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CLIENT & SWIMMING PROFILE

Client & Swimming Profile

CLIENT INFORMATION


NDIS Plan and Goals


CLIENT REPRESENTATIVE (If applicable)


SECONDARY EMERGANCY CONTACT


ABOUT ME


Likes


Dislikes




Client Photo



Circumstance


Health



Medical Contact Details


DECLARATION AND CONSENT FORMS


Swimming Profile

To ensure the safety and wellbeing of our clients, swimming activities are always undertaken at a minimum 1:1 support ratio.  


Additional comments


Swimming Waiver 



Self Administered Medication Authorisation (Participants Only)

Consent to Seek Medical Attention


Consent to Administer Medication


Consent for Future Contact


Consent to Share Information


Consent to Take, Store and Share/Publish Photography

I hereby give my consent for Inclusion Plus to take, display and/or share photographs and/or video of my family member/myself for use in:

- Media releases, media articles – including newspapers, radio, television, printed publications and other organisational marketing materials.

- Electronic publications and communications including Inclusion Plus Social Media Platforms and Website.

- I understand that publication of these images may result in my family member/myself being able to be identified in connection with the images/videos published.

- I authorise the use of these images without compensation to me. All prints, digital files and digital reproductions shall remain the property of Inclusion Plus Family Support Inc.

- This permission will remain valid and effective until written advice has been provided to the organisation withdrawing this authority.

- I authorise the use of images to be shared with other Families if in a Group photo when attending the school holiday program.



Authorisation

I confirm that all of the above information is true and correct as at the date of signing


Client/Client Representative



Sign Here
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