| Admin Fields | |
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| Event Name | 2024 LETR WA POLAR PLUNGE |
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| Form Fields | |
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| I'm registering as | Athlete |
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| Last Name | Mher |
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| Phone No. (Mobile) | 0408952305 |
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| Email | Email hidden; Javascript is required. |
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| My Special Olympics Club Is | Other |
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| Will you be bringing any family members or carers with you? | |
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| What is the name of the family member/carer? | Support worker |
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| Name of Family Member 1 | Non |
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| Acceptance | - Make sure everyone you would like to attend is listed, or they may not be able to attend they may not be able to attend the event.
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| Accessibility | |
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| Are you physically fit? | Yes |
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| Do you need help to participate? | Yes |
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| Uniform | |
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| Note | You must wear your Special Olympics Club polo shirt for this event. |
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| T-shirt size | L |
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| Covid | |
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| Covid vaccination status | Unvaccinated |
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| Comments | I would like to attend |
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