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First Name

Last Name

Organisation name
Relationship to WS family member
Date of birth
Address Line 1 *
Address Line 2
Suburb *
State *
Postcode *
Country *
Mobile phone *
Other phone
Secondary email
Media permission

Yes

I give express permission for photos to be used by WSFSG Vic for electronic and print materials (e.g. website, newsletter, social media, flyers)

Registration confirmation will be emailed to you.