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:
Ashburton - Tuesday 6:30-7:30pm
Ballarat - Morshead Park Saturday 9-10am
Boroondara Eagles - Kingswood College - Saturday 9-10am
Brunswick City - Friday 5:30-6:30pm
Clifton Park - Wednesday 20 November 10:45am-11:45am
Croydon Ranges - Saturday 10-11am
Darebin Falcons - Thursday 7-8pm
East Gippsland Utd - Wednesdays 20 Nov – 11 Dec
Fawkner Community Sports Hall - Thursday 21 November 10:45am-11:45am
Glen Eira - Thursday 6-7pm
Golden Plains - Thursdays 21 Nov - 12 Dec 11am-12pm
Kensington JSC - Wednesday 5:30-6:30pm
Knox Regional Football Centre - Monday 7-8:15pm
Leisuretime Sports Precinct Geelong - Friday 10:30-11:30am
Leopold FC - Thursday 5-6pm
Mount Eliza - Sunday 1 December 1:30-2:30pm
Mount Martha - Monday 6-7pm
Mount Martha - Saturday 9-10am
Mount Waverley - Saturday 23 November 9:30-10:30am
Mount Waverley - Saturday 30 November 9:30-10:30am
Pakenham Utd - Tuesday 6-7pm
Portland SC - Saturday 10-11am
Soccer5s Dandenong - Wednesday 7-8pm
Stawell - Friday 5:30-6:30pm
Surfside Waves SC Ocean Grove - Wednesday 10-11am
Warrnambool Wolves - Monday 5:30-6:30pm
Watsonia Heights - Saturday 9:45-10:45am
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 pre-existing medical or health conditions that may impact upon your ability to participate in Soccer Mums?
If so, please list these pre-existing medical or health conditions:
Emergency Contact Details: (Name, Mobile Number and Relationship to participant)
Are you associated with a 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?
Please read through and agree to the below terms and conditions before clicking Submit
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