You can always press Enter⏎ to continue
September & October Participant Attendance Form
September & October Program 2024
22
Questions
book now
1
Are you a registered Participant of Isabella Able NDIS Support Services?
YES
NO. SIGN UP!
Previous
Next
Submit
Press
Enter
2
Please confirm that you are one of the following:
*
This field is required.
Person filling in this form
I am the Participant
I am the Participant's NDIS Nominee
I am the Participant's Support Coordinator
Other
Previous
Next
Submit
Press
Enter
3
Full Name:
*
This field is required.
Details of the person filling in this form
First Name
Last Name
Previous
Next
Submit
Press
Enter
4
NDIS Nominee/Participant's Email
*
This field is required.
This is where the copy of this form will be sent
example@example.com
Previous
Next
Submit
Press
Enter
5
Full name of the Participant attending program
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
6
Select your program of support activities
Click on the picture to select the activity you wish to attend. Remember to choose as many as you wish!
Universal Everything - Monday 23rd September - 9.30 am to 4.30pm
Swimming & Slides- Tuesday 24th September - 9.30 am to 4.30pm
T-Rex Exhibition- Wednesday 25th September - 9.30 am to 4.30pm
Fortress Gaming -Thursday 26th September - 9.30 am to 4.30pm
Roller Skating - Friday 27th September - 4pm to 11pm
Library Cinema - Monday 30th September - 9.30am to 4.30pm
Clip & Climb - Tuesday 1st October - 9.30am to 4.30pm
Swimming & Slides -Wednesday 2nd October - 9.30 am to 4.30pm
House Down Under -Thursday 3rd October - 9.30am to 4.30pm
Hijinx Hotel Challenge Rooms - Friday 4th October - 4pm to 11pm
Melbourne Show - Saturday 5th October - 9am to 5pm
SIX Musical - Saturday 12th October - 12pm to 7pm
Hotel 520 Dinner & Dancing - Friday 18th October - 4pm to 11pm
Ability Music Festival Saturday 19th October - 5pm to 12pm
Ability Disco - Halloween Theme - Friday 25th October - 4pm to 11pm
Sphinx Hotel Kiss Tribute - Saturday 26th October - 5pm to 12pm
Previous
Next
Submit
Press
Enter
7
Activity & Program Expenses
*
This field is required.
Please choose the option that you prefer:
YES - I would like to have the activities and any expenses incurred with the program covered by the participant's NDIS plan.
NO - I do not want the activities and any expenses incurred with the program to be covered by the participant's NDIS plan. The responsibility for covering the program costs and expenses will lie with the Participant/Participants nominee.
Previous
Next
Submit
Press
Enter
8
Activity Costs - Please confirm that you agree to the following:
*
This field is required.
YES- I consent for the program activities and associated expenses to be funded from the participant's NDIS plan.
YES- There is sufficient funding available in the participant's plan to support the program activities and associated costs.
YES- The activities included in the program are aligned with the Participant's NDIS goals.
YES- The program activities facilitate the participant in acquiring skills, fostering independence, building relationships, and exploring new experiences.
Previous
Next
Submit
Press
Enter
9
I understand that the expenses related to the program, as well as any costs incurred, will be itemised in a separate invoice to clearly distinguish the expenses.
*
This field is required.
Yes
Previous
Next
Submit
Press
Enter
10
I acknowledge that I am making this reservation in advance to secure my spot, as tickets and/or accommodations need to be pre-booked and I will be billed for these costs.
YES - I understand
Previous
Next
Submit
Press
Enter
11
I understand that if the invoice remains unpaid within 30 days of receiving it, the responsibility for covering the activity costs and any associated expenses incurred with the program will fall on the Participant/Participants NDIS Nominee.
*
This field is required.
Yes
Previous
Next
Submit
Press
Enter
12
Please provide your signature below to indicate your agreement with the program's terms and conditions and the selected activities.
*
This field is required.
Clear
Previous
Next
Submit
Press
Enter
13
Please share any additional information or details that you would like us to be aware of.
If this question does not apply to you, feel free to skip it.
Previous
Next
Submit
Press
Enter
14
First up, what should we call you?
*
This field is required.
Please provide us with your full name
First Name
Last Name
Previous
Next
Submit
Press
Enter
15
Great! What is your email?
example@example.com
Previous
Next
Submit
Press
Enter
16
And your phone number please
Please enter a valid phone number.
Previous
Next
Submit
Press
Enter
17
Does the participant know that you are providing Isabella Able with their details?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
18
Please provide us with the Participants full name
Previous
Next
Submit
Press
Enter
19
What is your relationship with the Participant?
Previous
Next
Submit
Press
Enter
20
Awesome! So who shall we contact to get them signed up with us?
Please provide full name of the person we will be contacting to join Isabella Able's programs and support
Previous
Next
Submit
Press
Enter
21
What is their email & number?
example@example.com
Previous
Next
Submit
Press
Enter
22
Would you like to book in a FREE discovery call?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
22
See All
Go Back
Submit