Wind Down Wednesday Application

Opportunity Name
Opportunity Date Close

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Wind Down Wednesday Application
Wind Down Wednesdays are a safe, group environment to explore all things wellbeing, including gentle stretches, meditation, breathwork, and self-regulation and wind-down techniques, all while having some fun!

Who: Young Carers aged 6-10
Where: Online
When: 29 July to 2 September weekly on a Wednesday
Time: 4:00pm - 5:00pm

Carer Gateway

The Carer Gateway is an Australian Government funded initiative, designed to give carers access to support at critical points in their caring journey. Little Dreamers is a Carer Gateway partner. Please note, the Young Carer may be required to register with the Carer Gateway to participate in this program if they aren’t already as the program is generally funded by the Carer Gateway, but the Little Dreamers team will guide you through this process.
Young Carer Name

First NameLast Name
Young Carer Birthdate

DayMonthYear
2 digit day, 2 digit month, 4 digit yearPlease note: all participants for the Wind Down Wednesday Program need to be aged 9-12 years old.
Parent/Guardian Email
example@example.com
Parent/Guardian Mobile Phone
Please enter a valid phone number.Format: (0000) 000-000.
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Terms & Conditions

You need to agree with the Event Waiver conditions outlined here and the Cancellation Policy outlined here in order to attend this event.

The Photo & Media consent details are outlined here.
I confirm that I have read and understand the above and consent to the Waiver conditions provided.
Photo and media consent
Parent/Guardian Consent

I am signing this consent form on behalf of my child or legal ward, as their parent and/or legal guardian. Accordingly, all references to "I', 'me', 'my' or similar in this form insofar as they relate to images, recordings, story, full name or similar shall be taken to be references to my child or legal ward.
Parent/Guardian Name
Signature
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Any additional comments?
Should be Empty:

Wind Down Wednesday Application

Terms & Conditions

Parent/Guardian Consent