All Abilities Recreation - Expression Of Interest

Have you attended a Play On/WADSA event before?*

I have attended a Play On / WADSA event before

This is my first time

Please check the box below if you are applying on behalf of the person participating.

A family member or guardian

An agency or plan manager

Other

Participant details

First name*

Last name*

Phone*

Email for all correspondence*

Street Address*

Suburb*

Postcode*

Date of Birth

Please provide details of your disability.

Please select the required support ratio.

1:1

1:2

1:3

1:4

Do you receive NDIS funding?

Yes

No

First Name*

Email*

Last name*

Phone*

Date of your plan review

Please select the goals you hope to achieve by attending a All Abilities Recreation event.

Improving your health and wellbeing

Increase your community participation

Increase your independent participation in activities

Learn new skills

Make new friends

Other

Which All Abilities Recreation term/s are you interested in?

How did you hear about All Abilities Recreation?

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