Family Day ||  Inflatable World Werribee
Thankyou for your interest in attending our first family day in the September school holidays. 

Please answer the following questions so we can ensure a safe, fun and supported day.

Morning tea will be provided.  
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Full name *
Contact number *
Email address *
Brainwave child's full name 
 *
Date of birth *
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/
DD
/
YYYY
Additional family members 
What are the child’s siblings’ names? *
Are there any other family members attending e.g. spouses, what are their names? *
Does your child need any specific assistance or uses equipment for mobility and transfers (such as wheelchair or walking frame)?
Does your child have any allergies or medical conditions we need to be aware of?
If yes, please describe your child's allergies or medical concerns that you would like us to be aware of.
Please describe any other information that will help us determine the best supports for your child.
Does your sibling(s) require any additional support?
 *
If yes, please describe sibling(s) additional support needs
Thank you for completing this form, we will be in contact to confirm attendance and provide additional information. 
Whilst we have a number of Brainwave staff and volunteers to support you and make the day as enjoyable as possible, we do not have the resources to monitor everyone at all times. By allowing your child and sibling(s) to participate/attend, you retain and accept full responsibility for child and siblings' safety whilst they are involved in day. 

If you have any questions please reach out to leighann.nolan@brainwave.org.au. 
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