Family Registration

Step 1 of 3

Name(Required)

First Last

Email(Required)

Phone(Required)

Username - Create One(Required)

Password - Create One(Required)

Hidden

Username - RT Create One(Required)

Hidden

Password - Create One(Required)

Property Physical Address(Required)

Street Address Suburb City State Postcode

Please enter the children's ages, names and school year level separated by commas in each field. 6, Sarah, Grade 1

Ages(Required)

Childrens names(Required)

Grades(Required)

Current distance education/school of the air provider(Required)

Information about the family - a little background please.(Required)

Type of accommodation available to Tutors / Volunteers(Required)

Proof of ID - Drivers Lic Front(Required)

Drop files here or

Accepted file types: jpg, gif, pdf, Max. file size: 16 MB.

Proof of ID - Drivers Lic Back(Required)

Drop files here or

Accepted file types: jpg, gif, pdf, Max. file size: 16 MB.

Public Liability Insurance Certificate(Required)

Accepted file types: doc, pdf, Max. file size: 16 MB.

How did you hear about Bushed?(Required)

Comments

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

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