2024 Brisbane Para Powerlifting Sporting Wheelies Social Program

2024 Brisbane Para Powerlifting Sporting Wheelies Social Program

Expression of Interest
Participant/Volunteer details
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth (dd/mm/yyyy)*
Email*
example@example.com
Phone Number*
National Disability Insurance Scheme (NDIS)
Did you know that Social Sport participation may be claimable throught your NDIS plan using the below line items?

Capacity Building – Community Participation Activities (09_011_0125_6_3)

Core – Community Social Recreation Activities, Group based activities (04_102_0136_6_1)

NDIS - Community Participation Activities - 09_011_0125_6_3
YesNo
For more information contact:

Sporting Wheelies

Address: 2 Kilroe St, Milton QLD 4064

Email: sport@sportingwheelies.org.au

Internet: www.sportingwheelies.org.au

Ph: (07) 3253 3333
Should be Empty:

Participant/Volunteer details