KGI - REAL Online Program Application Form

About the REAL Online Program:

The Korin Gamadji Institute (KGI) is delivering its successful Richmond Emerging Aboriginal Leadership (REAL) program online.

Commencing in November, this four-week program provides Aboriginal and Torres Strait youth with access to REAL content and mentoring from cultural experts and Richmond Football club players. Registration is open to all Aboriginal and Torres Strait Islander young people aged 13 – 18.

PARTICIPANT PERSONAL DETAILS

Firstname *
Surname *
Address *

City *
State *
Postcode *
Phone *
Email *

DOB *
Gender *

PARENT/GUARDIAN DETAILS
(Only required if you are under 18 years of age)
I am currently aged 18 or over

Firstname *
Surname *
Address *

City *
State *
Postcode *
Phone 1 *
Phone 2
Email *

EMERGENCY CONTACT DETAILS
Same as Parent/Guardian

Firstname *
Surname *
Address *

City *
State *
Postcode *
Phone 1 *
Phone 2
Email *

STUDENT QUESTIONS

	What school do you attend? *


	What is your current year level? *

	Have you been involved in any other KGI programs? *

	Tee-Shirt Size? *

PARENT/GUARDIAN CONSENT

I give consent for my son/daughter to participate in the Online Richmond Emerging Aboriginal Leadership (REAL) program.

STUDENT CONSENT

I acknowledge that my registration for REAL Online means that I will follow the KGI REAL Online Code of Conduct:

I will communicate with other students and program staff in a respectful way.
I will listen to, and consider, the views’ of others.
I will report (to KGI staff) any comments or behaviours that make me, or other students, feel unsafe.
I will respect the privacy of others.

PHOTOGRAPH CONSENT

Photographs are often taken during the KGI REAL Program and can be used for promotional purposes. By consenting below, you give consent for KGI, the Richmond Football Club and program partners to use any photographs taken on the REAL Program for publicity purposes.