GymAbility - Expression of Interest
Child's name
First Name
Last Name
Address
Street Address
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Suburb
State
Post code
Date of birth
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Day
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Month
Year
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Aboriginal descent
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Torres Strait Islander
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Parent's/carer's Name
First Name
Last Name
Email
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example@example.com
Phone Number
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Phone Number
Secondary contact
First Name
Last Name
Phone Number
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Phone Number
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What are your child's interest? Eg music, animals, music
If your child has triggers, what are they? Eg loud environment, touching
What strategies have you and your child been successful with? Eg timers, visuals, taking a break, heavy / weighted work
Does your child have any movement limitations/ require any physical adjustments?
If your child has been diagnosed in the past, what is their diagnosis?
Does your child have any medical conditions? Peg fed, epilepsy / seizures, asthma, anaphylaxis
Any other important information you wish to disclose?
Do we have consent to share a photo or video of your child in club newsletters, promotional material or social media?
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