Apply to Join the Weekend Social Club Program!

Fill in the details below and one of our friendly team members will get back to you with more information about our social club sessions and how you can join our incredible program.

First Name of Participant *

Last Name of Participant *

Date of Birth (Participant) *

Guardian/Carer First Name

Guardian/Carer Last Name

Phone *

Email *

Do you have a current NDIS Plan?

Yes

No

How are your NDIS funds managed:

Self-Managed

Plan-Managed

NDIA-managed (Agency-managed)

Anything else you'd like us to know?