KORIN GAMADJI INSTITUTE
Expression of Interest - REAL Program Years 11 & 12

ABOUT THIS PROGRAM
Our Year 11/12 program is the third stage in the Richmond Emerging Aboriginal Leadership journey. This three-day, residential program expands participants understanding of the three key pillars of the REAL program.
2022 Dates
Saturday 9 April 2022 – Monday 11 April 2022
Registration is open to all young people who identify as Aboriginal and/or Torres Strait Islander and are completing Year 11 or Year 12 in 2022.

Program numbers are limited, and successful applicants will be notified 4-weeks prior to the commencement of the program.

The KGI is a place of safety, and welcomes all young people, regardless of their sexuality, gender, or ability.
PARTICIPANT PERSONAL DETAILS
First Name*
Surname*
Address*
City*
State*
Postcode*
Mobile*
Email*
DOB*
Gender*
Identification*
PARENT/GUARDIAN DETAILS(Only required if you are under 18 years of age)
I am currently aged 18 or over*
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*
DIETARY REQUIREMENTS
Do you have any dietary requirements?*
Please provide details*
PARENT/GUARDIAN CONSENT
I give consent for my son/daughter to participate in the REAL Program Years 11 & 12*
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.*
AFL CLUB SUPPORT
Which AFL football club do you support?