*** Registration ***
Date: Saturday 2nd June 2018

Friendship Group Latrobe is heading to Jump and Climb for some bouncing fun, followed by a Burger-licious dinner at Farmhouse Burger and Grill.

Venue: Jump and Climb 62 Eastern Road Traralgon
Farmhouse Burger and Grill 25/19 Kay St, Traralgon

Cost: $23 (Activity Cost + Bring money for dinner)

What to Bring:
- Wear comfortable jumping clothes
- Drink bottle
- Money for dinner $20-$30
- Warm jumper/jacket
- Medication & medication booklet if required

NDIS Benefits & Outcomes:
- Meeting new people and developing friendships
- Social participation in the community
- Meet new people and develop 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
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 in case of emergency?

Transport Pickup Option *

Where would you like to catch the bus from? Note: Participants will need to meet the group/staff at their closest train station.

Transport DropOff Option *

Where would you like the bus to drop you off at?

Thank you for your registration!
A confirmation email, including payment details will be sent to you shortly.

Please note that payments will need to be received up to 1 week before the activity, otherwise you forfeit your place.

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

Have a great day!
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