Booking a Lesson Please enable JavaScript in your browser to complete this form.Which location/surf school are you interested in? *Phillipa Anderson Surf School - NewcastleNewcastle Surf SchoolCronulla Surfing AcademySelect all that may apply and our friendly team will find a date and school that suits you.Ideal days that will suit you? *MondayTuesdayWednesdayThursdayFridaySaturdaySundaySelect all that apply and we'll do our best to match you with a day that suits!Participant's Name *FirstLastParticipant's Age *Participant's Pronouns *He/HimShe/HerThey/ThemContact Phone *Contact Email *Do you/the participant have any additional diagnosis which may impact upon safety or shift the ways we need to provide information and learning? *(I.e. for safety reasons does your child have a diagnosis of epilepsy, asthma that we should be aware of? Or, is your child dyslexic/ADHD and requires different learning choices etc)Participant’s water experience and knowledge of the ocean: *(Can the participant swim? Can the participant assess risk or is their confidence level above their skill level- i.e. will go out far without acknowledging risks)?To communicate I use : (Please select all that apply) * *Spoken LangueWritten LanguageSign LanguagePicture ExchangeCommunication DeviceSome of my interested include: *(Where possible provide us with some interests so we can connect with the participant on arrival- i.e. spiderman, paw patrol, Pokémon etc) I do have some sensory sensitivies: *YesNoIf yes, what type of sensitivity does the participant have? Eg: Visual, Auditory, Smells, Touch, Taste, Other (please describe): *If I get overwhelmed I may…. *(I.e. Provide any examples of stims which signify stress, does communication change and use sign/non speaking? Or what else could be signs the participant is starting to become dysregulated)What helps when i'm overwhelmed is.... *(I.e. provide some examples of things which the participant does find supportive in times of dysregulation)Comment or MessageSubmit
