Subscribe for V - Melbourne Women's Walking Club

ADULT VISITOR REGISTRATION FORM

Please complete the form below. If you are registering for the first time, the form will request entry of a username and password (a minimum of 8 characters, 1 uppercase letter, 1 lower case letter, and 1 special character such as $#?). Please record the username and password that you create as you will need this to log in. After completing the form, click SUBMIT to lodge your registration.

Account Information

Username*

Password*

Retype Password *

Preferred Name *

Last Name *

Address *

Suburb *

Post Code *

Country (if not Australia)

Email *

Mobile phone *

Emergency Contact Name, Relationship, & Mobile *

Photo Consent *

Health information

Please complete the Emergency Contact and Health Form and carry it in your pack at all times in a sealed plastic envelope. This information is for emergency use only.

Are you a friend of a current member? *

Yes

Please provide the member's name *

I have read and understood the requirements outlined in the Acknowledgement of Risk and Obligations of Temporary Members form and wish to join the activities of the Club

Please select here:

Yes

Captcha*