*** Registration ***
Date: Saturday 16th December 2017

Summer is here!
Come along for a boogie board, some beach cricket, and time with friends. We'll grab an icecream and lounge in the sun.

Venue: Inverloch Surf Beach
Time: 11am - 3pm
Cost: Bring $10 to cover an icecream and drink.

What to Bring:
- Medication Booklet & medication
- Lunch, Snacks & Drink Bottle
- Bathers, rash vest and towel
- Hat, sunnies and sunscreen
- Sunsmart clothes
Note: Please leave electronics at home...

NDIS Benefits & Outcomes:
- Social participation in the community
- Meeting new people and developing friendships
- Increase your capacity to access your local community
- Development of your life and independent living skills
- Improve and develop your communication skills
- Opportunity to access new activities and try new things
- Self care for carers and participants
Register Interest
Are you already registered for the Roadies South 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 to attend the Roadies South program.  You need to complete an intake with Interchange Gippsland. 
Please enter your details below and one of our Program Coordinators will contact you shortly to arrange your Intake Appointment.

Please include your name, the name and age of the participant, your mobile number, and the town/suburb where you live.
Please note that this is 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 during the activity time in case of an emergency?
Transport Departure Options *

Transport Return Options *

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

Have a fantastic day:)
Powered by Typeform
Thank you for your expression of interest - you will receive an email shortly to confirm a spot for {{answer_nt1D9DP0uKkl}} on the activity.

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

Have a great day!
Powered by Typeform
Powered by Typeform