ACTIVITY 1

Phillip Island Day Escape
Date: / Friday 1st July 2016
Time: / 8am – 4pm (including pick-up and drop-off)
Availability: / 6-8 places
Cost: / $236.00 (staff ratio 1:2)
What to bring: / Packed lunch, drink bottle, hat and sunscreen, money for personal spending

ALTERNATIVE OPTION

MCG Tour and Sport Museum – Richmond
Date: / Friday 1st July 2016
Time: / 8am – 4pm (including pick-up and drop-off)
Availability: / 6-8 places
Cost: / $236.00 (staff ratio 1:2)
What to bring: / Packed lunch and drink bottle, money for personal spending

ACTIVITY 2

Enchanted Maze and Arthur’s Seat lookout – Rosebud
Date: / Friday 8th July 2016
Time: / 8am – 4pm (including pick-up and drop-off)
Availability: / 6-8 places
Cost: / $236.00 (staff ratio 1:2)
What to bring: / Packed lunch, drink bottle, hat and sunscreen, money for personal spending

ALTERNATIVE OPTION

IMAX and Melbourne Museum – Carlton
Date: / Friday 8th July 2016
Time: / 8am – 4pm (including pick-up and drop-off)
Availability: / 6-8 places
Cost: / $236.00 (staff ratio 1:2)
What to bring: / Packed lunch and drink bottle, money for personal spending

BOOKING FORM

Please return Booking Form by: Monday 20th June, 2016

Name:
Date of Birth:
Contact details: / Home: Mobile:
Email:
Activity
(18+ year olds)
Please tick one activity only. / Friday 1st July
Phillip Island Day Escape / Activity 1
5
Friday 8th July
Enchanted Maze and Arthur’s Seat lookout / Activity 2
5

Please complete the following checklist of requirements:

Information / Yes / No / Additional Details
1:1 staff ratio
Anaphylaxis Management Plan
Epilepsy Management Plan
Communication Devices
Continence Aides
Medication
Transfers or Hoisting
Wheelchair
Other – Please specify

PLEASE NOTE:

·  If we do not fill all places, we may need to cancel the scheduled activities.

·  Pick up and drop off locations will be decided upon client registration to find the most suitable and central location. If possible we will try to arrange pick up from the family home.

·  Outdoor activities will be replaced with indoor options, if weather does not permit or unforeseen circumstances arise.

·  Staffing ratios are 1 staff to 2 children we support. If your child requires a higher staffing ratio, costs to access the activity will increase (Cost of 1:1 support: $426.00 per day).