After Dinner Walking Group Registration Form
The City of Sydney’s After Dinner Walking Group isfor older people who are living in Sydney, who are active and would like to exercise in a safe group of like-minded people, while seeing the city and its cultural eventsat night.If you would like to join the After Dinner Walking Group, please fill out your information below, sign the form and e-mail it to or mail it to Jessica Mayr, Harry Jensen Centre, 17 Argyle St, Millers Point, NSW, 2000. Jessica will contact you with details of the next walk.
Family Name: / D.O.BGiven Name: / Gender:
Address:
Home Phone: / Mobile:
Email:
Would you like information e-mailed to you about other activities? Yes/No Please circle
Emergency Contact Name & Phone:
Where did you hear about this group?
I understand that this is a community walking group and I will be walking along the city streets at night. I agree to attend the different walks at my own risk. I am aware that I am responsible for getting to and from the start of the walk myself. I understand that if Ihave any concerns regarding my level of skill or fitness or my ability to undertake any of the walks, I will seek independent medical advice. I am aware that City of Sydney staff are not authorised to give me advice in this regard.
Signature: / Date:
PRIVACY PROTECTION NOTICE
The intended recipient of the personal information provided by you is the Council of the City of Sydney. The supply of this information is voluntary and may be used by the Council of the City of Sydney for research purposes and to contact you in relation to future events. Your personal information may be accessed by you and the Council of the City of Sydney. A request to access, update or correct any information should be directed to the City of Sydney at the email address at the top of this form. The personal information collected will be stored by the Council of the City of Sydney, for the purposes indicated above, and will not be disclosed unless required by law.