Forms Testing

Become a Rebound WA Member

To start the membership process, please fill out this form.
    Please let us know if this is your first time applying for Rebound WA membership.
  • Name and Contact Information

    Please provide your name and contact information.
  • Member Details

  • NameDate of BirthDisability/Able BodiedWould you like to volunteer? (Yes/No)Gender 
    Add a new row
    Please fill out this information: - If you are an individual with the disability signing yourself up. - If you are a parent/guardian, please fill a row for yourself and a row for the child with a disability.
  • Ex. She/Her; They/Them etc.
  • Disability Information

    Information about your disability informs the the sport and recreational opportunities that are available.
  • Please share any additional medical conditions/history that may affect your participation in sport and recreation, such as asthma, allergies, etc.
  • Sport Details

    This information helps us suggest sport and recreation programs that you may be most interested in.
  • Emergency Contact Information

  • Is there any additional information you'd like to share with Rebound WA?

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

Did you know we host a range of activities for adults and children with disabilities to get active?

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