School Holiday Programs
Registration

Registration of interest:

Full Name of Participant

Your name and relationship (if you are registering for the participant)

Email

Phone Number

Enter Participant's Date of Birth

What school holiday program are you interested in?

Please list down participant's dietary requirements, allergies and other sensitivities, if any.

Does participant require wheelchair access or medication management during the activity?

Does participant have any behaviors of concern or any other relevant information that would help the team provide the best support during the activity.

Is the participant under an NDIS Plan? If yes, please write NDIS Number below. If no, please write "N/A"

NDIS Plan Type

NDIS Plan Start and Plan End (DD/MM/YYYY). Write N/A if not applicable

How did you learn about our School Holiday Programs?

For questions please indicate them below

School Holiday Programs Registration

Interested in our School Holiday Programs?

Thank you!

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Kairos Care Pty Ltd.

Contacts

Address

Working Hours