Register Your Interest – School Holiday Consent Form

Please complete 1 x form per child.

Please note when you register your child’s interest their attendance is not confirmed. A HelpingMinds team member will be in touch to confirm your eligibility for the program.

Bookings close five days before the start date of the program.

Parent or Guardian's First Name*
Parent or Guardian's Last Name*
Email*
Phone*
Child's First Name*
Child's Last Name*
Child's Date of Birth*
Please select the program you would like to register your interest for*
Does your child have a family member or a friend living with mental ill-health?*
- Yes
- No
Does your child have emotional difficulties or is at risk of developing mental ill-health?*
- Yes
- No
How did you hear about the program?*
Would you like to receive updates about future School Holiday Programs?*
- Yes
- No
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Learn more about mental health conditions

Anxiety

Bipolar

Borderline Personality Disorder

Depression

Psychosis

Schizophrenia

HelpingMinds respectfully acknowledge that we work on Aboriginal land and pay our respects to community members and Elders, past and present. Individuals pictured are models and are used for illustrative purposes only.

HelpingMinds is committed to embracing diversity and eliminating all forms of discrimination in the provision of health services. HelpingMinds welcomes all people irrespective of ethnicity, lifestyle choice, faith, sexual orientation and gender identity. For more information, see our Diversity Statement.

HelpingMinds prides itself on being an accessible and inclusive organisation, ensuring everyone who needs support is able to access the right service and receive the help they need. If you require accessible locations, an interpreter or translator services, please contact us. For more information, see our Disability Access and Inclusion Plan.

HelpingMinds respectfully acknowledge that we work on Aboriginal land and pay our respects to community members and elders, past and present. Individuals pictured are models and are used for illustrative purposes only.