IMF RAW New Group Registration Form

IMF RAW RUN LEADERS

IMF RAW New Community Group Registration

All new IMF RAW Community Groups must complete the registration form below, which acknowledges and accepts the terms of the IMF RAW Code of Conduct.

"*" indicates required fields

IMF RAW Community / Group*

Name*

Address*

State*

Email*

Phone Number*

Date of Birth*

Gender*

ABOUT YOU

I AM:*

My mob/tribe/country is:*

Shirt Size*

Shoe Size*

RAW Group & Session Details

Proposed Start Date

Details of sessions delivered:*

Estimated number of active RAW group members:*

Comments

Link to public RAW FB page:

Link to public RAW Instagram page:

Medical Information

Do you have any physical, medical or intellectual impairment that may affect your ability to coach?*

If Yes, please list any current or pre-existing medical conditions you have.*

Do you have any current or pre-existing sports injuries?*

If Yes, please list any current/recurring injuries.*

Accreditation and Experience

What accreditation have you complete below?

Community Run Leader*

Level 1 - Date Completed*

Level 2 - Date Completed*

First Aid & CPR*

First Aid Expiry Date*

CPR Expiry Date*

Working with Vulnerable People / Children card*

If you hold a WWVP card in more than one state please list your home state here and add the additional details in the 'Other relevant experience' section below.

State*

Card Number*

Expiry Date*

Your current job role/position and professional background.*

Other relevant experience, qualifications and/or certificate relevant to health, fitness, education, and coaching.

Signature*

Date*

Phone

This field is for validation purposes and should be left unchanged.

IMF RAW RUN LEADERS

IMF RAW New Community Group Registration

ABOUT YOU

RAW Group & Session Details

Medical Information

Accreditation and Experience

Have A Question? CONTACT OUR TEAM.

Contact Us

Email: kylie.y@imf.org.au

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