WRTS PRESTON Holiday Program SPRING 2025

WRTS PRESTON Holiday Program SPRING 2025

Expression of Interest & Preferences Agreement
Participant's Name*

First NameLast Name
Parent/Carer's Name:*

First NameLast Name
Phone Number*
Email*
example@example.com
Participant's Date of Birth*

DayMonthYear
Date
Please tick the level of support your child requires at the Kids Gym*

One Staff Member to One Child Ratio (1:1 Support)One Staff Member to Four Children Ratio (1:4 Support)1:4 in Gym, 1:1 on Excursions
Has this child attended a WRTS Group Session before?*

YESNO (If not, we will be in touch to arrange an induction session)
Second Participant's Name (insert sibling's details if relevant)

First NameLast Name
Date of Birth

DayMonthYear
Date
Please tick the level of support the second child requires at the Kids Gym

One Staff Member to One Child Ratio (1:1 Support)One Staff Member to Four Children Ratio (1:4 Support)1:4 in Gym, 1:1 on Excursions
Has the second child attended a WRTS Group Session before?

YESNO (If not, we will be in touch to arrange an induction session)
How many sessions per week would you like to book your child/children in for? (Maximum 3 days per week)*

123
Please tick your preferred Gym Only Session Time*

MORNING IN-GYM SESSION 9AM-12PMI DO NOT WANT THESE SESSIONS
Please tick any date you are interested in your child attending for the above timeslot (no limits on preferences)

FRI 19TH SEPT - Art Attack (Last Day of Term)SAT 20TH SEPT - Lotions & PotionsSUN 21ST SEPT - Lotions & PotionsMON 22ND SEPT - Sensory PouchTUES 23RD SEPT - Focaccia MakingWED 24TH SEPT - Make your own AquariumTHUR 25TH SEPT - Rainbow PancakesFRI 26TH SEPT (Pub.Holiday) - Spring SlimeSAT 27TH SEPT - Balloon AnimalsSUN 28TH SEPT - Balloon AnimalsMON 29TH SEPT - Spring BookmarksTUES 30TH SEPT - Sensory Paint+CollageWED 1ST OCT - Friendship CookiesTHUR 2ND OCT - Sock DecoratingFRI 3RD OCT - Choc Crispy BarsSAT 4TH OCT -Lava LampsSUN 5TH OCT - Lava LampsMon 6TH OCT (1st Day of Term) - Popcorn & Movie
Please select your preferred Gym Only Session Time*

AFTERNOON IN-GYM SESSION 12.30PM - 3.30PMI DO NOT WANT THESE SESSIONS
Please tick any date you are interested in your child attending for the above timeslot (no limits on preferences)

FRI 19TH SEPT(Last Day of Term) - Art AttackSAT 20TH SEPT - Lotions & PotionsMON 22ND SEPT - Sensory PouchTUES 23RD SEPT - Focaccia MakingWED 24TH SEPT - Make your own AquariumTHUR 25TH SEPT - Rainbow PancakesFRI 26TH SEPT (Pub.Holiday) - Spring SlimeSAT 27TH SEPT - Balloon AnimalsMON 29TH SEPT - Spring BookmarksTUES 30TH SEPT - Sensory Paint+CollageWED 1ST OCT - Friendship CookiesTHUR 2ND OCT - Sock DecoratingFRI 3RD OCT - Choc Crispy BarsSAT 4TH OCT -Lava LampsMon 6TH OCT (1st Day of Term) - Popcorn & Movie
Please select your preferred Session Time (Only 1:4 Support ratio available)*

COMBO DAY (GYM/EXCURSION) 9AM-3.30PMI DO NOT WANT THESE SESSIONS
Please tick any date you are interested in your child attending for the above timeslot (no limits on preferences)

FRI 19TH SEPT (Last Day of Term) - Art Attack / Lego CentreSAT 20TH SEPT - Lotions & Potions / IMAX 3D FilmMON 22ND SEPT - Sensory Pouch / 123 Boom! Real Life ArcadeTUES 23RD SEPT - Focaccia Making / Swim ClassWED 24TH SEPT - Make your own Aquarium / Rockin' ChefsTHUR 25TH SEPT - Rainbow Pancakes / rose RidingFRI 26TH SEPT (Pub.Holiday) - Spring Slime / Social FairSAT 27TH SEPT - Balloon Animals / Dino FestMON 29TH SEPT - Spring Bookmarks / Reptile EncountersTUES 30TH SEPT - Sensory Paint+Collage / RampfestWED 1ST OCT - Friendship Cookies / Swim ClassTHUR 2ND OCT - Sock Decorating / ZooFRI 3RD OCT - Choc Crispy Bars / Hijinx HotelSAT 4TH OCT -Lava Lamps / Gaming Exhib.Mon 6TH OCT (1st Day of Term) - Popcorn & Movie / Bounce
1:1 SUPPORT GROUPS (5 - 13yrs) COMBO DAY (1:1 Support Ratio Only)*

9AM-3PMI DO NOT WANT THESE SESSIONS
Please tick any date you are interested in your child attending for the above timeslot (no limits on preferences)

FRI 19TH SEPT (Last Day of Term) - Art Attack / Lego CentreSAT 20TH SEPT - Lotions & Potions / IMAX 3D FilmMON 22ND SEPT - Sensory Pouch / HooplaTUES 23RD SEPT - Focaccia Making / Swim ClassWED 24TH SEPT - Make your own Aquarium / Rockin' ChefsTHUR 25TH SEPT - Rainbow Pancakes / rose RidingFRI 26TH SEPT (Pub.Holiday) - Spring Slime / Social FairSAT 27TH SEPT - Balloon Animals / Dino FestMON 29TH SEPT - Spring Bookmarks / Reptile EncountersTUES 30TH SEPT - Sensory Paint+Collage / RampfestWED 1ST OCT - Friendship Cookies / Swim ClassTHUR 2ND OCT - Sock Decorating / ZooFRI 3RD OCT - Choc Crispy Bars / Inflatable WorldSAT 4TH OCT -Lava Lamps / Gaming Exhib.Mon 6TH OCT (1st Day of Term) - Popcorn & Movie / Bounce
TWEEN (9 - 13yrs) COMMUNITY EXCURSIONS (Only 1:4 Support Ratio available)*

Full Day Excursion (9 - 13 year olds) 12pm-6pmI DO NOT WANT THESE SESSIONS
Please tick any date you are interested in your child attending for the above timeslot (no limits on preferences)

SUN 21ST SEPT - Living Legends + GracelandMON 22ND SEPT - Bubble Show + CityWED 24TH SEPT - Rockin' Chefs + BounceFRI 26TH SEPT - MCG Tour + Sports MuseumSUN 28TH SEPT - Dino Fest + Werribee ZooMON 29TH SEPT - Luna ParkWED 1ST OCT - 123 Boom + MoondogFRI 3RD OCT - Trout Fishing + BBQSUN 5TH OCT - Gaming Exhibition. +FortressMON 6TH OCT - Bowling + Meal
TEEN (13 - 17yrs) COMBO DAY (1:4 Support Ratio available)*

Teen Combo Day (13 - 17 year olds) 12pm-6pmI DO NOT WANT THESE SESSIONS
Please tick any date you are interested in your child attending for the above timeslot (no limits on preferences)

SUN 21ST SEPT - Living Legends + GracelandTUES 23RD SEPT - Battlekart + ScienceworksTHUR 25TH SEPT - 123 Boom + MoondogSUN 28TH SEPT - Dino Fest + Werribee ZooTUES 30TH SEPT - Horseriding + PicnicTHURS 2ND OCT - Pastry Chef Class + HealsvilleSUN 5TH OCT - Gaming Exhibition. +FortressMON 6TH OCT - Bowling + Meal
TWEEN/TEEN EVENING EXCURSIONS (Only 1:4 Support Ratio available)*

Evening Extras Excursion 4pm-8pmI DO NOT WANT THESE SESSIONS
Please tick any date you are interested in your child attending for the above timeslot (no limits on preferences)

FRI 19TH SEPT - Bounce Super Session w DinnerMon 22ND SEPT - Hijinx Hotel + DinnerWED 24TH SEPT - Trivia (6-10pm)FRI 26TH SEPT - Drive In & DinnerTUES 30TH SEPT - Cinema + Brewery DinnerFRI 3RD OCT - Glow Mini Golf & Bowling
MEDIA CONSENT We occasionally post photos from the day on our Instagram and Facebook page to show the daily activities. No names are listed. Are you ok for your child’s image to be posted?*

YESNO
CANCELLATION POLICY I am aware of and agree to adhere to WRTS Australia's Cancellation Policy, as outlined below and agree to adhere to its terms. • Cancellations more than 48 hours before the Service – Full Refund/No Charge • Cancellations within 48 hours or NO SHOW - 0% Refund/Full Payment Required if participant's session can not be filled by another participant ________ Please note: WRTS’s Accounts Receivable Team will follow up any non payments in line with NDIS Policy and non payments will be reported to the NDIA. A re-fund can be left as a credit on a client’s account for future services. Refunds or Credit can not be used for Rock Shop Products.*

Yes
CANCELLATION POLICY PROCEDURE Please note Cancellations will only be accepted via WRTS Preston's email.*

I acknowledge this
NDIS GROUP PRICING GUIDELINE I understand that NDIS Pricing Guidelines require WRTS to outline our costs in our invoicing and separate out fees for Support hours, Gym Capital Costs, Non Face to Face Planning time and Travel Costs (where required). These line items will be outlined in our Group Invoices.*

I understand
WRTS AUSTRALIA 2025/2026 PRICING ARRANGEMENTS

Please see WRTS Australia's Updated Price Guide inline with the NDIS 2025/2026 Pricing Arrangements.
I acknowledge the updated pricing arrangements
OUT-OF-POCKET ACTIVITY FEE. I understand that all COMBO Days, Teen and Community Excursions incur an out-of-pocket fee to cover excursion activities and costs that the NDIS do not cover eg. tickets, supplies. Each Excursion's Out of Pocket Fee varies. The Out of Pocket fee for each day is indicated with a colour code on the program's flyer. This will be invoiced for separately and must be paid personally, not through funding, in a timely manner. The Out of Pocket Fee adheres to the same cancellation policy as above as activities and supplies are pre-booked/purchased to ensure the comfort of our groups.*

Yes, I understand and accept
OUT-OF-POCKET ACTIVITY FEE - Update to Policy Please note that any Out of Pocket Fees not paid within 30 days will then incur a $5 late fee for every week they remain unpaid.*

Yes, I acknowledge this change
COMPANION CARD If your child has a Companion Card, please send a photo of it to WRTS Preston by email or text to 0439369077 for us to keep on file. To apply for a Companion Card visit: https://www.companioncard.vic.gov.au/

Yes, my child has a Companion Card
DIETARY REQUIREMENTS & ALLERGIES Some activities have a food element to them. Does your child have any allergies/intolerances? If so, please provide details.
MEDICATION My child(ren) will require Medication to be administered by WRTS Preston during School Holiday Sessions:
HOLIDAY PROGRAM BOOKING CONDITIONS

I understand that by submitting this EOI Form, I am confirming my interest for We Rock the Spectrum - Preston's School Holiday Program for the days and programs I have indicated above.

I understand that by submitting this Expression of Interest Form, I will be allocated as many sessions as possible, according to my wishes. I will receive a Booking Confirmation email outlining these sessions.

After my participant receives the services, I will be charged for each session.

I understand that this EOI form will serve as a Service Agreement for the WRTS Preston Winter School Holiday Program.
By Signing this I agree to all Booking Conditions stated above: (PLEASE ENSURE YOU PRESS SUBMIT AFTER FILLING IN THE REMAINING QUESTIONS)*

Clear
Additional notes:
Should be Empty: