WheelTalk Booking Form About The WheelTalk inclusion awareness program is an initiative of Disability Sport & Recreation. It encourages students to think about diversity, acceptance and disability – with a primary focus on inclusion. Presented by Victorians with disability who are actively involved in sport and recreation, WheelTalk combines unique stories of lived disability with the opportunity to play up to an hour of either AFL Wheelchair or wheelchair basketball. All equipment is provided. WheelTalk sessions run for approximately 1.5 hours and can accommodate up to 30 students.About WheelTalk is ideally held on an indoor basketball court. Please contact us if you need help finding an appropriate venue.Pricing $399 for the first session, Monday-Friday $140 for every additional session on the same day If there is a break of more than one hour between sessions, there is an extra fee of $140 to cover the presenter's costs. Note that: The first session booked on subsequent days will cost $399. There will be an extra fee for schools that are more than 70km from our Fitzroy office and/or if overnight accommodation is required. Please contact us to discuss details All bookings will incur 10% GST. The pricing outlined above does NOT include GST. We will send you an invoice at the beginning of the month that your WheelTalk session is scheduled for. As a registered charity, our payment terms are 14 days. If you have any concerns, please contact us on: firstname.lastname@example.orgCancellations We require at least 48 hours’ notice if you want to cancel or reschedule your WheelTalk booking. If you give us less than 48 hours' notice, you will be charged the full fee. If you want to hold your WheelTalk session outside, we are not liable for cancellations due to wet weather. We recommend you plan for your session to be held indoors to avoid being charged the full fee in the event of wet weather.Contact detailsSchool name:*Contact person:*Contact person mobile number:*Contact person email:* School reception number:*Accounts payable email:* Venue address:* Street Address Town/City Post Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Which sport would you like included in your WheelTalk session?*AFL WheelchairWheelchair basketballPlease send me a booking reminder by:*Text messageEmailPhone callMap of the venue To help your WheelTalk presenter arrive at the venue on time, please provide a map that shows: the layout of the school/venue where the session will be held parking area for a car and trailer where to meet you. Upload your mapAccepted file types: jpg, gif, png, pdf.Important information*Please tick all that apply: The venue is wheelchair accessible The venue has accessible toilets We have indoor facilities in the event of wet weather We have portable goal posts / basketball rings We have footballs / basketballs What date would you like to book a WheelTalk session?*DateTimeYear levelGroup size Consent to photograph/film*Do you give permission for us to use any images or film, taken during your WheelTalk session, for marketing and communication purposes (including social media)? Yes No DonationWe ask all groups taking part in the WheelTalk disability awareness program to consider making a donation to Disability Sport & Recreation.Name:*This will be used in place of a signature.Date:* This iframe contains the logic required to handle AJAX powered Gravity Forms.