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Individual Registration Form
First name
Last name
Gender
*
Male
Female
Email
Post Code
Date of Birth
Which event you would like to participate?
Please select the event
How many participants will attend the event?
Approximate number of any participants in a manual wheelchair?
Approximate number of any participants in a power wheelchair?
Approximate number of any participants with a visual impairment?
Approximate number of any participants with a hearing impairment?
How many parents/carers will attend the event?
Mobile contact for the day?
Code
Phone
Do your participants require any additional requests?
The children registered under my responsibility have permission for Disability Sports Australia and its agents (including but not limited to, any photographer, interviewer, creative agency or media organisation) to use their images for marketing purposes. Please notify staff on the day of any participants who do not have permission to publish. (They will be given a bib to wear).
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