Daffodil Day 2026 : Register

Joining Team Goldfields Womens Health Care Centre

First Name *

Last Name *

Email Address *

Password*

Mobile *

Year of Birth *

Fundraisers under 15 require parent or guardian permission. Please provide their details below or call 1300 780 113 for more info.

Parent / Guardian First Name *

Parent / Guardian Last Name *

Parent / Guardian Email Address *

Parent / Guardian Phone *

Please provide your postal address for your FREE swim cap and welcome pack. *

(enter manually)

Address Line 1 *

Address Line 2

Town/Suburb *

Postcode *

State *

Country *

How many times have you taken part in the Daffodil Day Dip? *

Are you fundraising in honour of anyone? *

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I have read and agree to the Terms & Conditions and terms of participation plus my state’s Fundraising Guidelines and Privacy Policy. *