Soccer Mums Come and Try Session RSVP Form
To help Mums experience the program without worrying about commitment and payment, Soccer Mums offers free come and try events so you can try before you buy into a program!
Please select your Soccer Mums Location:
Altona City - Sunday 22 March 11-12pm
Altona City - Tuesday 25 March 5:30-6:30pm
Ashburton - Saturday - 9-10am
Aspendale - Term 2 - Monday 20 April - 7:30-8:30pm
Ballarat Morshead Park - Saturday 9-10am
Brunswick City - Friday 5:30-6:30pm
Casey Stadium - Wednesday 12:00-1:00pm
Chelsea FC - Wednesday 7-8pm
Craigieburn - Wednesday 26 Feb 6-7pm
Croydon Ranges - Saturday 29 Feb - 10:00-11:00am
Darebin Falcons - Wednesday 7-8pm
East Bentleigh - Term 2 - Saturday 25 April 9-10am
East Bentleigh - Term 2 - Saturday 2 May 9-10am
Glen Eira - Tuesday 6-7pm
Knox Regional Football Centre - Monday 7-8pm
Maribyrnong Swifts - Wednesday 6:30-7:30pm
Maribrynong Swifts - Saturday 10-11am
Middle Park - Wednesday 6-7pm
Middle Park - This Girl Can Vic - 25 March 6-7pm
Moreland City - Friday 28 Feb 6-7pm
Morwell Pegasus - Saturday 29 Feb 9-10am
Mount Martha - Friday 9:30-10:30am
Mount Martha - Saturday 9:30-10:30am
Mount Waverley SC - Saturday 9-10am
Nimble Hits - Thursday, 26 March - 11:00 till 11:45
Plenty Valley Lions - Tuesday 10 March 6-7pm
Plenty Valley Lions - Thursday 19 March 6-7pm
Portland SC - Saturday 11-12pm
Portland SC - Tuesday 5-6pm
South Gippsland Splash - Thursday 9:30-10:30am
South Yarra - Thursday 27 Feb - 5:30 - 6:15pm
Stawell - Friday 5:30-6:30pm
Sunbury United - Sunday 10-11am
Surfside Waves (Ocean Grove) - Wednesday 9:30-10:30am
Warrnambool Wolves - Tuesday 5:30-6:30pm
Watsonia Heights - Saturday - 10:00-11:00am
Whittlesea Council - Friday 27 March - 4:00-5:00pm
Year of Birth
Are you the parent or carer of any children in your household? This includes children over 18 years.
If so, what age group(s)?
18 and over
In the past week, on how many days have you done a total of 30 minutes or more of physical activity, which was enough to raise your breathing rate? This may include sport, exercise and brisk walking or cycling for recreation or to get to and from places, but should not include housework or physical activity that may be part of your job.
Does the answer to the above question about your activity include the Soccer Mums Free Come and Try Session?
How confident are you about being able to participate in physical activity on a regular basis?
(Not Confident at all)
0 is (Not Confident at all), 10 is (Extremely Confident)
Do you have any current injuries or pain that may impact upon your ability to participate in Soccer Mums?
If yes, Identify the location of each of your current injuries or pain (multiple selection available)
Thoracic Spine (middle back)
Lumbar spine (lower back)
Quadriceps (front of thigh)
Hamstrings (back of thigh)
Please provide more detail in regards to the above, i.e. left or right side, risk factors, medical advice provided by professionals, length of injury etc.
Example: Shoulder - Right Shoulder surgery in 2012, limited symptoms recently and shouldn't impact ability to participate in Soccer Mums
Emergency Contact Details: (Name, Mobile Number and Relationship to participant)
Are you associated with a Soccer Club?
If so, which Soccer Club?
If so, in what capacity?
My child or children play soccer
Where did you hear about the Soccer Mums Free Session Offer?
VicHealth Soccer Mums Social Media /Website
A friend or family member
Your Clubs Facebook page
Melbourne City FC Website/Social Media
VicHealth - This Girl Can Vic
If you have selected other, please specify below:
La Trobe University is evaluating the Active Women and Girls for Health and Well being and the Regional Sport Program, both support by VicHealth. La Trobe would like to talk to some participants more in-depth over the telephone about their experiences with the Soccer Mums Program. Participants will be randomly selected for an interview and reimbursed (a $50 Coles Myer Gift Card) for their time. Would you be willing to share your experiences?
Football Victoria, Melbourne City or La Trobe University will contact participants to obtain program feedback and understand your current physical activity post participating in the program. Please tick the box to indicate you are happy to provide feedback that will help improve the program.
Please read through and agree to the below terms and conditions before clicking Submit
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