Please be assured your answers will remain confidential.

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* 1. What activity are you participating in?

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* 2. What LGA area do you live in?

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* 3. What is your name?

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* 4. What is your email address?

Please be assured your email address is only used for activity related information.

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* 5. Contact Number

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* 6. Gender

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* 7. Year of birth?

  Year
Year

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* 8. What postcode do you live in? (Please enter your four digit postcode only)

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* 9. How would you prefer to be contacted? 

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* 10. Are you the parent or carer of any children in your household?
This includes children over 18 years.

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