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Join
Donate
About
About Challenge
What We Do
Leuk the Duck
Who we are
Our Values
Our Board
Our Ambassadors
Key Partners
Membership
About Membership
Become a Challenge Member
Update Member Profile
Member Stories
Programs
Emotional Support
Art Therapy
Massage Therapy
Music Therapy
Parent Support
Practical Support
The Challenge Family Centre
Holiday Accommodation
Hospital Support
Scholarships and Trusts
Social Support
Activity Days
Camps
Playgroup
Ticketing
Fundraising
Our Events
Diamonds
Challenge Ball
Allenby Golf Day / Gala
Our Campaigns
#DoingItForJarrod
A Day in May
Biggest Aussie Pie Night
Lace up for Challenge
Tackling Childhood Cancer
Tie A Ribbon for Challenge
How You Can Help
Fundraise for Challenge
Volunteer
News
Shop
Contact
Donate
September School Holiday Program Application Form
Family Movie Day – The Wild Robot at Village Cinemas Crown – Monday, 30 September
All immediate family welcome (member, siblings, and parents/guardians).
Would your family like to attend the Family Movie Day?
(Required)
Yes
No
Please list the first and last name of each family member attending (immediate family only):
(Required)
Olivigna Pasta Making Class – Thursday, 3 October
Members and siblings aged 5 – 8 years
Would you like to attend the Olivigna Pasta-Making Class?
(Required)
Yes
No
First and last name of Challenge member and sibling(s) attending:
(Required)
Other important information:
Do any of the listed applicants have physical impairments or limitations?
(Required)
For example: hearing, visual, seizures, requiring a wheelchair etc.
Yes
No
Please list and describe any impairments for each applicable family member:
(Required)
Do any of the listed applicants have behavioural or social difficulties?
(Required)
For example: ADD, ADHD, ASD, anxiety etc.
Yes
No
Please list the beahvioural or social difficulties for each applicable family member, and describe how we can support them if required:
(Required)
Do any of the listed applicants have allergies or dietary requirements?
(Required)
Yes
No
Please list allergies or dietary requirements for each applicable family member:
(Required)
Do you give Challenge permission to use photos of your child on our social media platforms (website, Facebook, Instagram, etc.)?
(Required)
Yes
No
Parent/Guardian Information
Parent/Guardian Name
(Required)
First
Last
Contact Number
(Required)
Contact Email
(Required)
Emergency Contact Name
(Required)
First
Last
Emergency Contact Number
(Required)
65288
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