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Details

COME & TRY - Port Phillip Residents - Over 55s

Sun 04 Oct 2026 10:00 - 12:00

34-38 Lakeside Drive, Albert Park, Victoria

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Are you attending this event?

Yes No

Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Name*

Address (residents of the City of Port Phillip only)* Max 255 characters

Phone number*

Email*

Date of Birth (over 55s only)*

Emergency Contact: Name & Phone Number*

Do you have any medical condition that may impinge on your participation in moderate physical activity?*

Yes

If YES, please give further details: Max 255 characters

I confirm I have the ability to swim 50metres*

Yes

No (you will be required to wear a PFD)

I understand the risks involved in commencing a new physical activity and I am aware of the dangers associated with water sports. I hereby accept full responsibility for my own health and safety whilst participating in this program.

By ticking this box, I accept*

Yes

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

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