Neurodiverse Program

Neurodiverse Program
Southern Districts Basketball will be conducting Introductory Small Group skills sessions tailored to the needs of neurodiverse participants.

The 2 introductory sessions will be held on the 23rd and 30th of November at Brisbane Bayside College between 10am and 2pm. Each session will run for 45 minutes (30 minutes on court + time to meet and discuss individual experience and needs)

The groups will be allocated according to age, experience and needs, with a maximum of 4 participants in each group.

To register, please complete the form below. Prior to the session you will be contacted and provided with further details including your session time, name of your coach and a map showing how to find the basketball court at Brisbane Bayside College.
Participants Full Name

First NameLast Name
Participants Preferred Name
Date of Birth

MonthDayYear
Date
Gender
Parent/Guardian/Caregiver Name

First NameLast Name
Relationship to Participant
Contact Number
Please enter a valid phone number.
Email address
example@example.com
Emergency Contact

First NameLast Name
Relationship to Participant
Contact Number
Please enter a valid phone number.
Support Needs
Please describe any specific needs or support requirements for the participant (e.g., communication, mobility, behavioural considerations):
Does the participant have any sensory sensitivities we should be aware of? (e.g., sound, light, textures)
Are there specific methods that help the participant manage stress or anxiety?
Does the participant have a special interest area?
Learning & Communication Preferences
Does the participant respond well to specific learning techniques? (e.g., visual aids, hands-on instruction, step-by-step demonstrations)
Are there preferred communication methods? (e.g., verbal, non-verbal cues, flashcards)
Program Goals
What are your primary goals for the participant in this program? (e.g., socialisation, skill development, fitness)
What is the basketball experience/level of the participant?
Is there anything specific you would like us to focus on in sessions?
Medical Information
Does the participant have any medical conditions, allergies, or medications we should be aware of?
Are there any physical restrictions we need to accommodate?
NDIS Information (if applicable):
Does the participant have an NDIS plan that covers Capacity Building - Health & Wellbeing or Improved Daily Living budgets?
Parent/Caregiver Involvement
Would you be interested in helping with the sessions?
Are there specific areas where you would like to be involved?
Media Consent
Do you consent to images and videos of the participant being taken during sessions and used for social media or promotional purposes?
Additional Information
Is there any other information that would help us create a positive experience for the participant?
How did you hear about this program?

My Products

2 x Introductory neurodiverse sessions

$10.00AUD

Total

$0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Neurodiverse Program

Support Needs

Learning & Communication Preferences

Program Goals

Medical Information

NDIS Information (if applicable):

Parent/Caregiver Involvement

Media Consent

Additional Information