Active Teens Participant Form

Please complete this form to let us know you'd like to join the 8-week Active Teens Health & Wellbeing Program on Saturdays. Once this form is complete, a registration form will be sent to your parent or guardian to fill out.

If you need help completing this form, please contact Alannah on 02 4621 8713 or Alannah.Romeo@health.nsw.gov.au

First Name *

Last Name *

Date of Birth * +

What school do you attend? *

Phone Number

Parent / Guardian Phone Number *

Email Address

Parent / Guardian Email Address *

How did you find out about the Active Teens Bootcamp? *

I wish to participate in the Active Teens Bootcamp

I do not wish to participate in the Active Teens Bootcamp

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