Activity Submission Form Leader Name Date Type of Activity Walk Cycle Paddle Training Trip Away Meeting Social Miscellaneous Activity Title [eg Stuart Park to Thirroul, Mt Keira Ring Track] Activity Description [eg highlights, terrain and other conditions] Visual Code Specific Hazards eg: Slippery Rock Platform, Bike Route includes heavy traffic section Specific Abilities eg: Paddling on fast moving water, Clambering over rocks. Distance Km (Use number format only ie 30) Duration Hr (Use number format only ie 2.5) Grade 1 2 3 4 5 Pace Leisurely Moderate Energetic Registration Essential Not Required Limit Meet 10 mins prior at Activity start time