Play Well - How to Participate

Your interest in this research project is greatly appreciated! You may use the form below to register your interest in participating.

Please complete this form at your convenience, and submit. Following submission, you will be contacted to arrange the best way for you to be involved in the research.

Participate

Your Name:

Mobile phone number:

Email address:

I am:

A parent of a child aged up to 12 years enrolled in junior rugby league this season.

Child's first name (if you have multiple children enrolled in junior rugby, please nominate one child to focus on during the study):

Junior Rugby League Club:

Age Group:

Team Name:

Do you have a partner who is also interested in taking part in Play Well?:

Yes
No

Partner's name:

Partner's mobile phone number:

Partner's email:

Play WellPlay Well

Play Well - How to Participate