Relationship to Participant. Allow access to: ☐ NAPPA – NDSP Online Portal ☐ Monthly statements Copy of guardianship document provided? ☐ YES ☐ NO
Relationship to Participant. Allow access to: ☐ NAPPA – NDSP Online Portal ☐ Monthly statements Consent to share Information: ☐ YES ☐ NO
Relationship to Participant. Allow access to: ☐ NAPPA – NDSP Online Portal ☐ Monthly statements Consent to share Information: ☐ YES ☐ NO ☐ Yes ☐ No NDIS registered providers are required to be audited against the NDIS Practice Standards as part of the NDIS Quality and Safeguarding Framework. Clients of NDSP are automatically enrolled in the audit processes and may be contacted by the (NDSP) audit team for interviews and/or have their files reviewed to ensure NDSP is compliant. If you do not wish to participate in the audit you can opt out of the process by ticking the box below. ☐ I do not wish to be part of the audit process.
Relationship to Participant. Phone(s):
Relationship to Participant. Contingent Beneficiary(ies) & relationship to partcipant:
Relationship to Participant. In consideration of the opportunity to participate in the use of the skate park at 00000 Xxxx Xxxx Xxxx, Xxxxxxxxxx XX 00000 in Isle of Wight County (the “Skate Park”), the undersigned Participant hereby agrees as follows:
Relationship to Participant. Signature of Minor Participant (if applicable) Print Name (Minor Participant)
Relationship to Participant. Phone Number of Emergency Contact: ( )
Relationship to Participant. Phone(s): We assume this is a text-able number, but please make a note if not. Second Additional Emergency Contact Name: Who should we contact next if there's an emergency during camp? Relationship to Participant: Phone(s): We assume this is a text-able number, but please make a note if not.
