Registration For NDIS Activities

Participant Name *

Email *

Phone *

Address

Date of Birth

NDIS Number

NDIS Plan Start Date

NDIS Plan End Date

Plan Managed By:

Plan Manager Details

Preferred Location

Select Activities Available at Dingley Village

Select Activities Available at Werribee

Any Special Request

Sovereign Lives Victoria Community Participation SERVICE AGREEMENT *

I accept the following terms and conditions.

Core budgets in your NDIS Plan can be used to provide supports such as to assist a participant to engage in community, social and recreational activities during the week (including weekends and public holidays).

As Registered NDIS Service Providers, Sovereign Lives Victoria charge fees at the rate set by the National Disability Insurance Agency for core supports.

If transport is required, Sovereign Lives Victoria can provide that on additional cost. All expenses in relation to transport, will be billed back to your plan under activity based transport code.

The cost for service of group centre activities will be charged as per NDIS price guide.

Your Rights

You have a right to be communicated with respect

You have a right to choose to give feedback

You have a right to accept or refuse service

You have a right to complain or express grievances about Sovereign Lives Victoria or operations

Our rights

We have a right to be communicated with respectfully

Fellow participants have a right to be communicated with respect

We have a right to terminate service if the terms and conditions are not adhered to.

If a worker thinks they are unsafe, then the participant will be asked not to return.

Your responsibilities

To advise us of any changes to your contact details

To respect the rights, privacy and dignity of Sovereign Lives Victoria Counselling staff and other participants

To take responsibility for yourself and the results of any decision

To not drink alcohol on any group outing

To make sure you stay with the group and advise staff if you need to leave the group for any reason.

Make sure you behave in accordance with instructions from staff

Treat all group participants with respect and courtesy

To advise staff if you have or believe you may have an infectious illness

To advise staff of any allergies or supports you require for safe participation

COVID-19 restrictions

If you have a cough or any type of respiratory illness, please stay at home. If you turn up to the group feeling ill, you will be asked to leave as we are required to facilitate a safe environment for all.

We take the health and safety of our staff and participants very seriously. If you feel ill, please give us a call and provide minimum 24 hours of notice. If you provide less than 24 hours notice, you will be charged the total hours that was quoted as part of you will be charged the total hours that was quoted as part of the service agreement.

Terms and conditions

If you need to cancel or postpone the appointment, please provide a minimum of 2 business days’ notice. If the appointment is cancelled within this time, the total hours that was quoted as part of the service agreement, will be charged. This will be charged from the core supports bundle in the plan. If an event is not taking place, you will be advised prior to the event.

If your plan manager does not pay the invoices within 14 days of invoices been raised, you will not be able to participate in the group activities until the account is paid up to date.