NDIS Disability Support | Client Care First NSW

Outside School Hours Care including Vacation Support Enquiry Form

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If you plan to register multiple kids/participants, please submit another form.

Parent/ Carer's Full Name:

Email:

Phone:

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Child Details

Child's / Participant's First Name

Child's / Participant's Last Name

Child’s / Participant’s Date of Birth

Child’s / Participant’s Gender

Child’s / Participant’s School (Put N/A if not applicable)

Child’s / Participant’s Allergies and Dietary Requirements

Child’s / Participant’s Diagnosis (Please also include any significant medical conditions e.g. epilepsy)

Child’s / Participant’s Medications (Please provide full details of any medications that need to be administered during support hours. If applicable, ensure medications are provided in a Webster Pack for accurate and secure dosing. A Sign-In and Sign-Off Sheet must also be completed to document administration)

Child’s / Participant’s Day-to-Day Strengths and Limitations (optional)

Child’s / Participant’s Behaviour Support Plan and Any Other Reports (e.g. occupational therapy, any restrictive practices)

Please upload the Child’s / Participant’s Behaviour Support Plan and any other reports (e.g. occupational therapy, any restrictive practices)

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Outside School Hours Care including Vacation Support Enquiry Form

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