BBQ Day Warilla - 22nd December

BBQ Day

Reddall Reserve, Warilla

7:30 am - 11:30 am

Friday 22nd December 2023

First Name *

Last Name *

Mobile Phone Number *

This session will be run at a cost of approx. $97.05 to the NDIS plan (exlcuding kilometres) *

I agree for this to be added to a Schedule of Supports for the Summer Program.

Signature

Draw signature|Type signatureClear

Do you currently receive Support Work from Real Life Assistants?

YesNo

Please Include your NDIS Number, Date of Birth, Plan Dates and Plan Manager (if applicable) *