Active Moves Plan Managed NDIS Details My Active Moves Participant will be attending Rainbow Club in the upcoming term. I am unable to submit my Plan Manager 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 *FirstLast Moves Name Plan NDIS Number *Active Moves Location *Plan ManagerEmail Address for Invoices *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 this active moves participant has the appropriate funding for Rainbow ClubI acknowledge that (copy) *I authorise Rainbow Club to invoice the Plan Manager at the end of each monthI acknowledge that (copy) (copy) *I understand that if my Plan Manager does not pay the fee invoice, I will be responsible for the payment in fullI acknowledge that (copy) (copy) (copy) *I authorise Rainbow Club staff to submit the Service Agreement on my behalfParent/Carer Name *FirstLastSignature * Clear Signature Date *Submit See our Locations
