Inclusive Sensory Session Registration Form
Please provide information requested below. Data collected is confidential and will be used to provide a report for Sport Canterbury to show who has benefited from these sessions. Thank you!
*This event is for enthusiastic roller skaters. It is preferred you bring your own roller skates or blades. Skates are available for hire from sizes US1 - 14
Which session are you hoping to attend?
*
Saturday July 27th at Woodend Community Centre
Skater Details:
Full Name
*
First Name
Last Name
What suburb do you live in:
*
Suburb
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Age:
*
Ethnicity:
*
Gender:
*
Male
Female
Non-Binary
Prefer not to say
Other
What is most important for your child?
*
Low lighting
Low volumed music
A non-judgemental space
Breakout option available
Neurodiverse educated coaches
Other
If selected Other, Please Specify
Do you require a Social Story to be sent to you?
Yes
No
Please provide any other necessary information:
Do you require skate hire? Sizes US1-14 available. First in first served on the day of the event.
*
Yes
No
If skate hire is required, what size skate do you need?
For any other information please contact Alana at hello@canterburyskating.com
Disclosure: Inclusive Sensory Sessions are proudly supported by Sport Canterbury Tū Manawa Fund. All personal data is confidential and used to provide an end of activation report that will support our future events. Alana is a registered Social Worker turned Roller Skater Coach and has experience in a number of different areas of children's' wellbeing. Canterbury Skating Academy coaches are First Aid trained and Police checked.
Submit
Should be Empty: