2023 Sporting Wheelies Social Programs- Term 3

2025 Social Sports Programs - Term 1

Online Registration Form
Sporting Wheelies hosts weekly social sports programs in Boccia, Wheelchair Basketball, Para Powerlifting and Wheelchair Fundamentals. The programs are aimed at players of all abilities and levels.

Cost: Participation in our programs range from $160 to $540 per individual for the 8-week term. Please note player registration is for the entire 8 week term.

Timing: Each social sport program runs for a 0.5 to 2 hour session.

Registrations: All athletes must register prior to participation. Registration is for the full 8-week term.

Program Dates:
- Boccia term dates - Click HERE
- Wheelchair Basketball term dates - Click HERE
- Wheelchair Fundamentals term dates - Click HERE
- Para Powerlifting term dates - Click HERE
- Adaptive Aquatics - Click HERE
Participant 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*
Classification*

I have a sport classificationI don't have a sport classificationI am not eligibleI would like to be classifiedOther
Type your sport classification
Additional details about the impairment (if relevant for the coach to know):
To assist us with our session planning and to ensure we meet your needs, please indicate below the key outcomes that you are looking to achieve through the Social Sport Program.*

Social Benefits: Make new friends, be part of a team, have fun with othersPhysical Benefits: Build strength, improve/maintain function, increase fitnessBuild confidence, improve communication skills, turn takingImprove skills to play competitive/social sportComplement other current therapy goals (ie: Physiotherapy, Occupational Therapy)Other
Emergency Contact
Emergency Contact *

First NameLast Name
Emergency Contact Phone Number *
Support Worker Contact

(If applicable)
Support Worker Contact

First NameLast Name
Support Worker Phone Number
National Disability Insurance Scheme (NDIS)
Will you be paying with NDIS (if paying with NDIS a service agreement will be sent to you before the start of the program):*

YesNo
NDIS Number*
Are you plan, self or agency managed?*
Name of plan manager company*
Email of plan manager company*
Phone number of plan manager company*
Please select which NDIS code you would like to use (select one):*

NDIS - Group Activities - Standard - Weekday Daytime - 04_102_0136_6_1NDIS - Access Community Social and Rec Activ - Standard - Weekday Daytime - 04_104_0125_6_1NDIS - Community Participation Activities - 09_011_0125_6_3
- Registration is for the entire 8-week term; If you wish to cancel participation for a term, you will need to contact The Association via email: sport@sportingwheelies.org.au or phone 3253 3333 a minimum of 7 business days prior to the start of each term.
- If you do not provide a minimum of 7 days notice, you will be charged the full term fee.
- Extenuating circumstances will be considered on a case by case basis. Please request in writing to via email: sport@sportingwheelies.org.au
Payment
NOTE: If you would like to use a Fairplay Voucher as part payment for the term fees, please email the voucher number to sport@sportingwheelies.org.au within 5 business days and proceed with the form submission. We will then apply the discount to the term fees.
NDIS Participants

If paying with NDIS a service agreement will be sent to you before the start of the program. Please proceed with the submission of the online registration form without finalising a payment.

Please Note:
- Registration is for the entire 8-week term; If you wish to cancel participation for a term, you will need to contact The Association via email: sport@sportingwheelies.org.au or phone 3253 3333, a minimum of 7 business days prior to the start of each term.
- If you do not provide a minimum of 7 days notice, you will be charged the full term fee. Extenuating circumstances will be considered on a case by case basis. Please request in writing to via email: sport@sportingwheelies.org.au
- If you wish to cancel participation for a term, you will need to contact The Association via email: sport@sportingwheelies.org.au or phone 3253 3333 a minimum of 7 business days prior to the start of each term.
My Programs*
prevnext( X )
Boccia - Moreton Bay - Saturday (10 - 12pm) - Morayfield Sport Centre$320.00AUD

Boccia - Brisbane - Wednesday (4.30 - 6.30pm) - 2 Kilroe Street, Milton $320.00AUD

Boccia - Hervey Bay - Wednesday (12.30 - 2.30pm) - 9 O'Rourke Street, Pialba$160.00AUD

Wheelchair Basketball - Brisbane - Tuesday (5 - 7pm) - 2 Kilroe Street, Milton$320.00AUD

Wheelchair Basketball - Toowoomba - Saturdays (11.00am - 13.00pm) - St Mary's CBA, 235 Herries St$320.00AUD

Wheelchair Basketball Refereed Games - Brisbane - Tuesday (7:15pm - 8:15pm) - 2 Kilroe Street, Milton $160.00AUD

Wheelchair Fundamentals - Brisbane - Monday (6.30- 8.00pm) - 2 Kilroe Street, Milton $200.00AUD

Para Powerlifting - Brisbane - Wednesday (3:30 - 5:00pm) - 2 Kilroe Street, Milton$160.00AUD

Adaptive Aquatics - Brisbane - Fridays (30 min private session)- QUT Gardens Point Pool$540.00AUD

Adaptive Aquatics - Brisbane - Saturdays (30 min private session) - QUT Gardens Point Pool $540.00AUD

Total $0.00AUD
My Products (NDIS)*

Boccia - Moreton Bay - Saturday (10 - 12pm) - Morayfield Sport Centre - $320.00 AUD - NDISBoccia - Brisbane - Wednesday (4.30 - 6.30pm) - 2 Kilroe Street, Milton - $320.00 AUD - NDISBoccia - Hervey Bay - Wednesday (12.30 - 2.30pm) -9 O'Rourke Street, Pialba - $160 AUDWheelchair Basketball - Brisbane - Tuesday (5 - 7pm) - 2 Kilroe Street, Milton - $320.00 AUD - NDISWheelchair Basketball - Toowoomba - Saturdays (11.00am - 13.00pm) - St Mary's CBA, 235 Herries St - $320.00 AUD - NDISWheelchair Basketball Refereed Games - Brisbane - Tuesday (7:15pm - 8:15pm) - 2 Kilroe Street, Milton - $160 AUD - NDISWheelchair Fundamentals - Brisbane - Monday (6.30- 8.00pm) - 2 Kilroe Street, Milton - $200.00 AUD - NDISPara Powerlifting - Brisbane - Wednesday (3:30 - 5:00pm) - 2 Kilroe Street, Milton - $160 AUD - NDISAdaptive Aquatics - Brisbane - Fridays (30 minute private session) - Kelvin Groove - $540 AUD - NDISAdaptive Aquatics - Brisbane - Saturdays (30 minute private session) - Kelvin Groove - $540 AUD - NDIS
Terms and Conditions
Member / Participant Terms and Conditions

SPINAL LIFE AUSTRALIA LTD. ABN 39 293 063 049 also known as Sporting Wheelies, (the Association).

By clicking the submit button, I, the Member / Participant listed below:

1. Note that Sporting Wheelies is committed to providing an environment that promotes positive behaviour and values, one that is free from all forms of harassment, discrimination and abuse, and one that is safe for children. I agree to support this endeavour and to conduct myself in an appropriate manner at all times.
2. Agree that I am bound by and will comply with the rules, policies, procedures and Codes of Conduct of Sporting Wheelies and Sporting Wheelies Services as provided to me and/or published on the Sporting Wheelies website from time to time.
3. Agree to present the Sporting Wheelies in a positive manner in the community.
4. Agree to abide by all lawful directions of Sporting Wheelies staff and designated volunteers.
5. Acknowledge that failure to comply with such rules, policies, procedures and Codes of Conduct may result in my being suspended or banned from future participation in Sporting Wheelies services.
6. Understand that participating Sporting Wheelies Services, particularly physical activity can carry some risk, and there is the chance of physical injury.
7. I accept all risks arising from and associated with Sporting Wheelies Services and participate entirely at my own risk and with full appreciation of the nature and extent of risks involved.
8. Confirm that I am physically fit and able to participate in Sporting Wheelies Services and understand that I will be required to complete a medical assessment or obtain a medical clearance in order to participate, if deemed necessary by the Sporting Wheelies staff.
9. I understand that using the facilities provided by the Sporting Wheelies is at my own risk, and acknowledge that this use may involve risk of injury, whether caused by myself or another party. By accepting this Agreement I agree that Sporting Wheelies will not be liable for any loss, injury, damage or theft of property, belonging to or brought onto Sporting Wheelies premises by myself, or for any death, personal injury or illness on Sporting Wheelies premises, or from using our facilities or equipment. I understand that this release does not apply if death or injury results from gross negligence on Sporting Wheelies part.
10. Understand that a reference to Sporting Wheelies Services is a reference to any event, competition, service, program or activity, including sport, recreation, gym, rehabilitation and fitness, operated and/or offered by Sporting Wheelies.

Privacy - Collection Notice

1. Sporting Wheelies is collecting your Personal Information to facilitate membership and / or services requested by you and /or to keep you informed about Sporting Wheelies Services. We may contact you in the future for the promotion of services, products, education, research, fundraising, activities and events.
2. Communications from us may include mail, email, social media, SMS or telephone contact and may also include messages on behalf of sponsors and other third parties. Your Personal Information will not be provided to third parties without your consent unless we are required by law to do so. By providing your information to us you agree that you have provided your indefinite consent to this contact. You may withdraw consent at any time though in doing so we may not be able to provide you with services requested.
3. Further information about your privacy is available from Sporting Wheelies on request.

Media & Photography consent

I give consent to the publication and/or use of my name, image, voice, statements or otherwise, via any medium before, during or after participation in Sporting Wheelies Services, whether for advertising, promotion or otherwise, without payment or compensation.

I give consent to be photographed or filmed and for these images and / or audio to be used in various mediums to promote Sporting Wheelies.

If you wish not to be photographed or filmed please fill out our Athlete Photography Opt-Out Form here - https://forms.office.com/r/zJyFh65r6y
Terms and Conditions*

I have read, understood and agree to the above Terms and Conditions declaration
For more information contact:

Sporting Wheelies

Address: 2 Kilroe St, Milton QLD 4010

Email: sport@sportingwheelies.org.au

Internet: www.sportingwheelies.org.au

Ph: (07) 3253 3333
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2025 Social Sports Programs - Term 1

Participant details

Emergency Contact

Support Worker Contact

National Disability Insurance Scheme (NDIS)

Payment

Terms and Conditions