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Your Enquiry
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Traveller Details
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Who is the primary contact for this booking?
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Self
Someone Else
Other Contact
This could be the person making this booking or an emergency contact
Name
First
Last
Email
*
Phone
*
Other contact's relationship to the traveller
Friend
Family
Service Provider
Guardian
Parent
Personal Representative
Is this person assisting you with this booking?
Yes
No
Name of the person assisting you with this booking
First
Last
Phone Number of Person Assisting you with the booking
Guest Service Planning
Have you completed a Guest Services Plan or Booking Summary?
Yes I am a returning Guest
Yes I have provided a New plan
No I am completing soon
I would like assistance with this
Unsure or Other
My holiday and support services style is...
Active paced low support (1:4)
Relaxed paced low support (1:4)
Relaxed paced high support (1:2)
Relaxed paced high support (1:1)
Unsure or Other Support Preferences
Do you have any Itinerary or mobility related accessibility requirements?
No Mobility Aids / Good Mobility
No Mobility Aids / Low Mobility
Travelling with Walking Aid Stick
Travelling with Manual Wheelchair
Travelling with Electric Wheelchair
Please describe any special requests...
for example accessibility, dietary requirements, allergies, or other requests
Do any of the following apply to this booking?
NDIS Funding
NDIS Participant Number
*
Trustee Approvals
Trustee Contact Person
*
First
Last
Trustee Email
*
Guardian Approvals
Guardian Name
First
Last
Guardian Email
What is the best time to for the team to contact you to complete your holiday reservation?
preferred day of the week and/or time
Would you like to receive our newsletter which includes updates on new holidays?
Yes
Phone
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