FLING Community Class Registration for NDIS & Supported participants 2024
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Student Name: *
Date of Birth: *
MM
/
DD
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YYYY
Gender: *
Emergency Contact Name: *
Emergency Contact Number: *
Email: (for class communications) *
Plan Management Contact Name: *
Plan Management Contact Number: *
Plan Management Contact Email (billing and plan management): *
What class/es are you enrolling in? Tick all that apply *
Required
Are there any Medical Conditions that may impact this young person at FLING? *
Does this young person have any Neurodiversities which may impact them at FLING? *
Does this young person have any access requirements to support them in the space at FLING? *
Are there any behavioural triggers we need to know about to support this young person in the space? *
I give permission for basic first aid to be given if needed and if necessary for medical assistance to be called. *
Required
I have ambulance cover *
Required
MEDIA RELEASE: I give consent for photographs, images, videos, voice or written quotes being recorded and I release these documents to be used in newspaper, radio, television, website and social media for the purpose of FLING Physical Theatre publicity or posters. *
Required
How did you hear about us? *
Signed *
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