PRE-EVENT SURVEY

Please fill in as much information as you can on this form to assist Disability Sports Australia in assisting you the participant and the family, carer, guardian, or teacher in helping the participant reach their social activity goals.

Identified Gender
Disability Type (please select the most appropriate below)
Does the participant currently participate in PE at school?
Does the participant currently participate in schools sports carnivals? If so, which of the following have they actually physically raced or competed in. Please select any that they hae participated in during the two (2) years?
Does the participant regularly see any of the following support health professionals to assist with therapy or staying active?
How does being active make you feel?

This next section is called CAN I PLAY, it is information we gather from each student and family to assist them in funding the participant to be more active, more often with the right adaptions for their needs within community recreation activities and community sports clubs.

Does the participant currently participate in community sport?
Would the participant like to continue to do any activities within their community after they attend Activate Inclusion Sports Day?
Does the participant currently work with an NDIS Local Area Coordinator or Early Childhood Early Intervention Coordinator within their community?
Does the participant currently access any State Government Sport Vouchers to assist with the costs of participating in sport or activity?
Does the participant currently access any NDIS Goal Related to Activity funding to assist with the costs of participating in sport or activity?

If the participant, family, carer, guardian or teacher helping the participant filling in this survey would like help from Disability Sports Australia in linking to funding or activities please list your name, relationship to participant, phone and or email address for us to support you to help get started.

Thank you for completing this feedback form.

Information provided will be only used by Disability Sports Australia and our AISD partners to improve service delivery quality.