July 2024 Winter School Holiday Program
for Kids with Special Needs 7yrs +

Participant's First name*

Participant's Last name*

Date of birth*

Parent/Carers Full Name*

Email*

Phone number*

Mobile phone number*

Full Address*

Will you require transport to/from home?*

Yes

No

Will medication need to be administered whilst in our care?*

Yes

No

Does your child have a Plan-Managed or Self-Managed NDIS plan? *

July 2024 Winter School Holiday Programfor Kids with Special Needs 7yrs +