RLCG Big Bash League Groups Referral Form

This is a social group for fans of cricket to come together at Warrilla Sports Club to watch the Big Bash League and enjoy dinner every friday night (excl. public holidays)

Group times would run from 6:00PM - 11:00PM from 19/12/2025 to 23/01/2026

Referrer Details

Referrer Name *

Relationship to the person being referred

Phone Number

Email Address

Participant Details

Full Name *

Email Address

Address *

Emergency Contact InformationPlease include name, phone number and relationship if possible

Support Level *

I require 1:1 supportI require 1:3 support

Plan Details

I have previously received supports from RLCG

How is the plan managed? *

Self-ManagedPlan ManagedAgency Managed

Plan Manager Information *Please include name, contact number and email if possible

Plan Start Date

Plan End Date

RLCG Support FacilitatorOptional; please answer if you are already receiving supports from RLCG

Support CoordinatorPlease include name, contact number and email if possible