School Holiday Groups
Child's Information
Child's Full Name
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First Name
Last Name
Child's Date of Birth
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Parent/Caregiver Information
Parent/Caregiver Full Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
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example@example.com
Group Selection
Which group(s) are you interested in enrolling your child in?
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Mighty Mitts (5-7 years) - Tuesday 30th September, 11:00am - 11:45am (NDIS: $93.75, Private: $35)
Mighty Mitts (8-12 years) - Tuesday 30th September, 1:00pm-1:45pm (NDIS: $93.75, Private: $35)
Early Achievers (4-6 years) - Thursday 2nd October, 11:00am-1:00pm (NDIS: $250, Private $85)
Team Triumph (8-12 years) - Thursday 9th October, 11:00am-1:00pm (NDIS: $250, Private: $85)
How will you be paying?
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Private Paying
NDIS Funding
Health & Safety
Does your child have any medical conditions, physical limitations, or injuries we should be aware of?
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Does your child have any behavioural or sensory needs we should consider when participating in a group setting?
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Is your child able to follow group instructions with minimal support?
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Yes
No - Needs support
If no, please describe the level of support they may require:
Goals
What are your main goals for your child joining this group? (for example: building strength, emotional regulation, confidence, social skills)
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Additional Information
Do you have any questions, concerns or additional information you'd like to share?
How did you hear about this group?
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Submit
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