School Holiday Program Registration
Participant Name:
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Date of birth
*
/
Day
/
Month
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
*
Please Select
Newspaper
Internet
Magazine
Other
Spring School Holiday program
Canberra - Wed 1 Oct
Firetruck/Campfire - Thurs 2 Oct
Wheels and Grow - Wed 8 Oct
Thredbo - Thurs 9 Oct
Frolf and Fairways - Fri 10 October
Parents/Gurdian Name
*
First Name
Last Name
NDIS Number
*
NDIS Plan Start Date
*
/
Day
/
Month
Year
Date
NDIS Plan End Date
*
/
Day
/
Month
Year
Date
Funding Management
*
Please Select
NDIA Managed
Self Managed
Plan Managed
Plan Manager Details (if applicable)
Please list any Allergies or extra information regarding support needs
I give consent for photographs and/or videos to be published via various forms of media such as Social Media, Website, Organisation or promotional materials and Education and training purposes
*
Yes
No
The schedule of activities provided is a general guide only. Activities may be modified on the day to suit the needs, abilities, and interests of the children attending. Flexibility ensures a safe, inclusive, and engaging experience for all participants.
*
I agree
By signing this form, I acknowledge and consent to the Spring School Holiday Program being charged to my NDIS plan. Charges will be applied in accordance with U Care We Care’s current price guide and service agreement.
*
I agree
By signing this form, I acknowledge and consent to the Spring School Holiday Program being charged to my NDIS plan. Charges will be applied in accordance with U Care We Care’s current price guide and service agreement.
*
I agree
To ensure fair access and planning, cancellations must be made at least 48 hours prior to the scheduled session. Cancellations made with less than 48 hours’ notice may incur a full session charge, in line with NDIS short-notice cancellation guidelines. Exceptions may be considered in cases of illness or emergency, with appropriate documentation.
*
I agree
U Care We Care offers home pick-up and drop-off services for eligible participants. Transport availability is subject to location, staffing, and scheduling capacity. Requests for transport must be made in advance and confirmed prior to the program start date. Transport charges will be applied in accordance with the current price guide and may be claimed through the participant’s NDIS plan if applicable.
*
I agree
Submit
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