KIAMA CHANGEMAKERS PROGRAM FORM 2026

KIAMA CHANGEMAKERS PROGRAM

Sign Up Form
When:

Tuesdays - 4:30pm to 6:30pm

Term 3 and 4, 2026
Changemakers will allow you to:
- Design and create your own social or environmental project to create positive change in your community
- Connect with like-minded young people
- Be mentored by inspiring youth leaders
- Learn how to look after your own mental health and wellbeing - while supporting your friends too.
Participant Information
Name:
Preferred Name:
DOB:
Year Group:
Preferred Pronouns:
Contact Number:
Format: (000) 000-0000.
Email:
example@example.com
Do you identify as Aboriginal or Torres Strait Islander? Please select.
Do you have any allergies, health or wellbeing concerns? If so, please provide details.
Parent/Guardian Consent Form
Parent/Guardian name:
Relationship to Participant:
Contact Number:
Format: (000) 000-0000.
Email:
example@example.com
I give permission for my child to take part in the Sonder Youth Changemakers Program on Tuesdays from 4:30pm to 6:30pm in Term 3 and 4, 2026. I understand that anything contributed to or created during the Changemakers Program belongs to the program, and ownership, copyright, payment or approval rights won't be claimed.
Media Release: I give permission for my child to be interviewed/photographed/filmed during the program and understand and agree that any interview/photography/film may be used for marketing purposes.
Signed
Date

MonthDayYear
Date
For more info please visit www.sonderyouth.com/changemakers
team@sonderyouth.com | 0403 652 303 | www.sonderyouth.com
Should be Empty:

KIAMA CHANGEMAKERS PROGRAM

When:

Changemakers will allow you to:

Participant Information

Parent/Guardian Consent Form