Coles Community Round Pre-Registration Form

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We are excited to be holding Coles Community Round from 17th - 27th of February 2022 for NSW, ACT and VIC. The first 200 Centres to pre-register will recieve a selfie frame, go in the draw to win an athlete visit and Coles digital gift cards. Pre-registrations close Sunday 6th of Feb or until allocation is exhausted.

First Name *

Last Name *

Centre Name *

Position held at Centre *

State/Territory affiliated with *

Email *

Phone number *

C/O Business or Company

Street Address *

Suburb *

Postcode *

State *

Do you give authority to leave? *

YES

Date holding Coles Community Round (to be held between 17th - 27th February 2022) *

YYYY

Program Start Time for Round *

Time

Program Finish Time for Round *

Time

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