GROUP Social Skills Groups Registration Form LEAP Brisbane 2025 Term 1

Social Skills Groups Registrations 2025

Program *

Term

Term 1Term 2Term 3Term 4

LEAP maximum cost *

Ashgrove, Brisbane

When: Every Tuesday during school term
Time: 10.00am to 12.00pm
Location: Hear and Say, 29 Nathan Avenue, Ashgrove Qld 4060

Please select the date(s) you're registering for Brisbane LEAP for Term 1 *

Parent / carer first name *

Parent / carer last name *

Email address *

Child's first name *

Child's last name *

If siblings are also attending please list their names below

Please list any dietary requirements

Do you have a NDIS plan? *

YesNo

NDIS plan start date *

NDIS plan end date *

NDIS plan number *

How manage NDIS plan *

Self managedAgency managedPlan managed

NDIS plan manager name *

By registering you agree to pricing conditions above and confirm that you have sufficient funds in your NDIS plan for this social and life skills group. You acknowledge that NDIS prices are subject to change, and recognise the price listed in your Service Agreement may not reflect the updated price listed on our website. *

I agreeI don't agree

Photo and video consent

I give permission for Hear and Say to take photographs and/or video recordings of my/our child and myself/ourselves during events and activities organised or provided by Hear and Say. I understand that the photographs and/or video recordings may be used and published by Hear and Say on our platforms which may include our website, social media, press releases, reports, resources and collateral, and funding agreements. I also understand that these photos/videos may be shared with other organisations outside of Hear and Say.I do not give consent.

Subscribe

I want to receive information about offers, services, products, events, and fundraisers that Hear and Say thinks may be of interest to me or surveys including by mail, email, SMS, social media, or other forms of communication. I understand I can unsubscribe from these communications at any time.

Privacy Policy

I acknowledge that I have read the Privacy Policy. *