Volunteer Registration

Please complete the details in the form below. Our Volunteer Coordinator Traci Bevan will be in contact with you shortly.

Your Details

First Name *

Last Name *

Please select your date of birth on the calendar * +

Street Address *

Address Line 2

City *

Postcode *

Contact Phone Number *

Other Phone

Email Address *

What is your preferred method of communication? *

Post

Phone

Please tell us who we should contact in the event of an accident or medical incident (i.e. next of kin)

I.C.E. - First Name *

I.C.E. - Last Name *

I.C.E. - Contact Phone Number *

What is their relationship to you? (i.e. they are your spouse, partner, mother, father, adult daughter, adult son) *

Would you consider yourself a physically fit person? (i.e. are you able to lift 20kgs/be on your feet for extended periods of time) *

Yes

Comment if required Comment if required

Do you have any medical conditions you feel we should be aware of?