SUPERHIRO Wednesday Registration

First Name

Surname (required)This field is required

Email (required)Please enter your email addressPlease enter a valid email address

Mobile

Name of school, workplace, club or community group (required)This field is required

State (required)Please select one or more valuesPlease select one or more values

Tell us who will be involved? (required)Please tick a checkbox

SchoolWorkplaceHouseholdCommunity Other

honeybeeritb2

Sign up for our newsletter

First name (required) Please enter your first name

Last name (required) Please enter your last name

Email (required) Please enter your email address Please enter a valid email address (e.g. [email protected])

Head Office: c/- WorkLocal, 2/503 Ballarat Road, Sunshine VIC 3020 | Tel: 03 9094 3718 | Email: [email protected]