Registering for yourself or as a parent/guardian *

Registering for yourself

Registering as a parent/guardian

First Name *

First Name *

Last Name *

Last Name *

Email *

Email *

DOB *

DOB *

Gender *

Male

Female

Address *

Address *

Town *

Town *

Post Code

Post Code

Parent/Guardian First Name *

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian Last Name *

Emergency Contact Mobile *

Emergency Contact Mobile *

School Name / Organisation *

School Name / Organisation *

Teacher/Organiser's Name *

Teacher/Organiser's Name *

I would like to receive an information package about pursuing paddling in Western Australia

I acknowledge as the Participant or as the Guardian that this form completes the enrolment process for the SunSmart Paddle Academy program.*

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