Expression Of Interest Form - Telethon Kids Carnival
On Friday 25 October, the Gymnastics WA circuit will be featured on a pre-filmed slot to promote the carnival on Channel 7. Athletes between the age of 6-13 will be required to tackle the circuit activities while the filming takes place to showcase the Gymnastics WA circuit. If you are interested please complete the form until Friday the 4th October 5pm.
Club
Club's Contact Name
First Name
Last Name
Club Email
example@example.com
Name of athlete #1
First Name
Last Name
Age of athlete #1
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
Name of athlete #2
First Name
Last Name
Age of athlete #2
6 years
7 years
8 years
9 years
9 years
10 years
11 years
12 years
13 years
Can both athletes attend on Friday the 25th October between 9.30am - 11.30am?
YES
NO
Photo Permission
YES
NO
Will both of your athletes be accompanied by a parent/guardian?
YES
NO
Parent/guardian contact athlete #1
First Name
Last Name
Parent/guardian contact email athlete #1
example@example.com
Parent/guardian contact phone athlete #1
-
Area Code
Phone Number
Parent/guardian contact athlete #2
First Name
Last Name
Parent/guardian contact email athlete #2
example@example.com
Parent/guardian contact phone athlete #2
-
Area Code
Phone Number
Submit
Should be Empty: