KORIN GAMADJI INSTITUTE
REAL Program Sign Up Form
PROGRAM
Select A REAL Program*
PARTICIPANT PERSONAL DETAILS
First Name*
Surname*
Address*
City*
State*
Postcode*
Mobile*
Email*
DOB*
Gender*
Identification*
PARENT/GUARDIAN DETAILS
First Name*
Surname*
Address*
City*
State*
Postcode*
Email*
Mobile*
EMERGENCY CONTACTS DETAILS
Same as Parent/Guardian*
First Name*
Surname*
Address*
City*
State*
Postcode*
Email*
Mobile*
PARENT/GUARDIAN CONSENT
I give consent for my son/daughter to participate in the selected REAL Program.*
PARTICIPANT CONSENT
I acknowledge that my registration for KGI Programs means that I will follow the KGI Programs Code of Conduct:*
  1. I will communicate with other students and program staff in a respectful way.
  2. I will listen to, and consider, the views of others.
  3. I will report (to KGI staff) any comments or behaviors that make me, or other students feel unsafe.
  4. I will respect the privacy of others.
PHOTO CONSENT
Photographs are often taken during the KGI Programs and can be used for promotional purposes. By consenting below, you give consent for the KGI, the Richmond Football Club and program partners to use any photographs taken on programs for publicity purposes.*
PRIVACY COLLECTION STATEMENT
The Richmond Football Club Ltd (Club / we) is committed to protecting the privacy of personal information we collect. The Korin Gamadji Institute (KGI) is a division of the Club. We will only use the personal information provided in this application form for the purposes of:
  1. assessing and processing the participant for the KGI program;
  2. communicating with the participant and/or their parent/guardian about the KGI program;
  3. contacting the participant's parent/guardian and/or emergency contact during the operation of the KGI program if required;
  4. improving the experience of, and services to, KGI participants and KGI programs (eg surveys); and
  5. providing information about future KGI programs, KGI events or other community programs via email unless the participant and/or their parent/guardian opt out of receiving such emails by either:
    1. ticking the checkbox below; or
    2. emailing info@kgi.org.au to unsubscribe.
We may disclose the personal information in the application form to others for administrative, educational and health related purposes in the operation of the KGI programs. We may also disclose the participant's personal information to a third party to lessen or prevent a serious threat to the participant's safety or welfare (if required), or when required by law (such as government departments or agencies). From time to time, we may publish media releases about the KGI program via various channels (including our website, social media and newsletter) or those of our approved partners which may include or feature the name and/or image of the participant provided they have provided they and/or their parent/guardian have given their consent. We will otherwise not disclose any of the personal information to any third party without the participant's and their parent/guardian's consent.

Our privacy policy is available at www.richmondfc.com.au/privacy which contains further details about how an person can access or correct information we hold about them; how they can make a privacy related complaint; and how that complaint will be dealt with.
I have read and agree to the items in this Privacy Statement*
I do NOT want to receive information about future KGI programs, KGI events or other community programs.