HIGH FIVE
JUMP & CLIMB EXTRAVAGANZA!
*** Activity Registration ***
Date: Wednesday 10th April 2018

High Five will be heading to Jump and Climb in Traralgon to experience both the jumping and climbing activities!

Venue: Jump & Climb, Traralgon
Time: 10.00am - 1.00pm
Cost: $35.00

Note: Drop off & pickup will be at at Jump & Climb Traralgon

What to Bring:
- Medication (if required)
- Companion Card
- Lunch, snacks & drink bottle

NDIS Benefits & Outcomes:
- Meeting new people and developing friendships
- Social participation in the community
- Improve and develop your communication skills
- Opportunity to access new activities and try new things
- Self care for carers and participants
Register Now
 
Are you already registered for the High Five program with Interchange Gippsland? *

Note: if you are not currently registered for this program, you will have the opportunity to contact Interchange Gippsland for and Intake Appointment with one of our Program Coordinators.
     
 
Hi there, you mentioned that you're not currently registered for the High Five program with Interchange Gippsland. We would love to help you in any way we can...
Please enter your details below and one of our Program Coordinators will contact you shortly to arrange an Intake Appointment.

Please note your name, the name of the participant, your mobile number, and the town/suburb where you live.
 
Please note that this Registration acts as an Expression of Interest only... you will be contacted to confirm if the participant is eligible for the activity - this eligibility is dependent upon staff:participant ratios, priority of access, and making sure that we can best cater to the requirements of each of our participants.
Once eligibility is confirmed, you will receive a registration link to enable payment of the activity prior to the activity date.

 
What's your name? *

 
What's the name of the Interchange Gippsland Participant who will be attending the activity?

 
Thanks for that, what's the best phone number to catch you on?

 
Emergency Contact Details *

Who is the best person to contact if an emergency occurs during the activity? If other, include name & phone number.

 
Please note that the group will be meeting at the activity venue, there is no transport provided for this activity...

Thank you for giving us your contact details... one of our Program Coordinators will be in touch shortly.

Have a fantastic day:)
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Thank you for your expression of interest - you will receive an email shortly to confirm a spot for {{answer_qVgO3tR39OaE}} on the activity.

If you have questions, feel free to contact us on 1300 736 765.

Have a great day!
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