Active Moves NDIA Managed Details My Active Moves Participant will be attending Rainbow Club in the upcoming term. I am unable to submit my NDIA details online. Please submit on my behalf. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Active Moves Participant Name *FirstLastNDIS Number *Active Moves Location *NDIS Plan Start Date *NDIS Plan End Date *Funding Support Category to Use *Core Supports - Support Budget: Assistance with Social, Economic and Community ParticipationCapacity Building - Support Budget: Increased Social and Community ParticipationCapacity Building - Support Budget: Improved Health and Wellbeing - Exercise PhysiologyCapacity Building - Support Budget: Improved Daily Living/Daily Activity - Exercise PhysiologyCore Supports - Support Budget: Group and Centre Based ActivitiesThe NDIS Quality and Safeguards commission has approved Rainbow Club’s registration as a registered NDIS provider under section 73E of the National Disability Insurance Scheme Act 2013 (NDIS Act). The most recent certificate of registration is dated 08 November 2024 and covers Social and Community Participation and Group and centre-based activities. I acknowledge that *I confirm that funds are available in this plan for Rainbow Club fees *I authorise Rainbow Club to make a service booking on the NDIS portal for fees *If there are no NDIA Managed funds available for Rainbow Club to use, I agree to pay the term fees directly to Rainbow Club by credit card Support Parent/Carer Category Parent/Carer Name *FirstLastSignature * Clear Signature Date *Submit See our Locations
