2017 Junior JORG Registration
Registration for casual attendance
Child's Name (If multiple please add all names in the text box below) *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Mobile *
Your answer
Email Address *
Your answer
Mobile Number *
Your answer
Address *
Your answer
Date of Birth *
Your answer
Please list any medical conditions, medications, allergies or injuries we should be aware of
Your answer
I confirm I am physically fit enough and medically able to participate in this training. I accept that I take part at my own risk and that the organisers cannot be held responsible or liable for any personal accident, injury, loss or damage to personal effects that may arise as a result of my participation. *
Required
I consent to the use of my name, image and also my performance in events, at any time, to promote JORG by any form of media. *
Required
Please note there is $10 cash fee for casual sessions please bring along with you to your session.
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