LifeConnect Group Registration

I want to join a LifeConnect group

Name *

First name

Last name

Phone number *

Email address *

Address *

Address line 1

Address line 2

Town/Suburb

City

Postcode/Zip

Gender *

Age bracket *

LifeConnect group

Select your preferred group

Message

YES, I give consent for my details to be passed on to a LifeConnect group leader *

Please tick the box to give permission for your details to be passed on.

Preferred contact method

If no option is selected, the LifeConnect group leader will contact via their preferred method.

You will receive a confirmation email once you click submit. Please check your junk folder if you do not find it in your inbox.

Information collected is treated as confidential under the Privacy Act 2020. Data is stored and secured by Infoodle. Their privacy policy is available at https://www.infoodle.com/privacy-policy