Application for a trial session.
Complete this application form to apply for a 30 minute trial session with Spectrum Fitness and Wellbeing. The investment for a trial session is $65.
Email address *
Your name *
Your answer
Your phone number *
Your answer
Your child's name *
Your answer
What music does your child like? *
Your answer
What characters / movies / TV shows etc. does your child like? *
Your answer
Will you be using NDIS funding to pay for your child's coaching? Note my services are registered under 'Capacity Building - Health and Wellbeing'. *
If you are using NDIS funding and you have a plan manager, please list their name, phone number and email address. (Write N/A if not applicable.) *
Your answer
The minimum monthly investment for in-person coaching is $240 for one session per week, for a 12 month commitment. Is this within your budget? *
I confirm that my child does not have a history of violence with therapists, carers and / or teachers. *
Required
I confirm I agree to the terms and conditions listed at http://www.spectrumfw.com/terms-and-conditions. *
Required
Please complete the Child Pre-Exercise Screening Tool at http://www.spectrumfw.com/wp-content/uploads/2018/10/Agreement_SPECTRUM_2018.pdf and bring to your child's trial session. *
Required
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