anyone aged 18 - 25 living with Type 1 diabetes. $100. Only. 4 star hotel in. Sydney. 23rd - 25th ... MULTIPLE DAILY INJ
Only
$100
SYDNEY Weekender A fantastic getaway for
anyone aged 18 - 25 living with Type 1 diabetes.
SYDNEY Weekender is a fantastic getaway for anyone aged 18 to 25 living with Type 1
diabetes. It’s a chance to come together, meet new people and get the latest tips on how to make your life a little easier. Through a mix of group discussions, workshops and fun activities, you’ll get the answers to all your questions, as well as a great opportunity to connect with others. It won’t all be about Type 1 though! There will be plenty of time to relax and have a good time. We will be exploring Sydney on a day trip and get involved in a cooking class to help you prep and plan your food. Partners are welcome to attend and get involved too.
Cost
$100
Bringing your partner? They’ll pay $150
23rd - 25th Feb 2018
4 star hotel in Sydney
To Apply: Fill in the application form and scan or post it back to Diabetes NSW & ACT
Places are limited to 30 spots Applications close Sunday 14th January 2018 The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. The NDSS agent in NSW & ACT is Diabetes NSW & ACT. In NSW, syringes and disposable needles under this scheme are co-funded by the NSW Department of Health.
APPLICATION FORM Sydney Weekender 2018
Preference will be given to those that have not attended Sydney Weekender previously. FULL NAME: ADDRESS: POSTCODE: PHONE:
DOB:
/
/
SEX:
MALE
MOBILE: FEMALE
EMAIL: HAVE YOU ATTENDED A DIABETES CAMP IN THE PAST?
YES
NO
YEAR
HAVE YOU ATTENDED THE SYDNEY WEEKENDER EVENT?
YES
NO
YEAR
DIABETES EDUCATOR OR DOCTOR’S NAME & ADDRESS OR PHONE NUMBER:
SPECIAL DIETARY REQUIREMENTS: ALLERGIES OR OTHER ILLNESSES: SPECIAL NEEDS: DIABETES MANAGEMENT:
SYRINGES OR PENS
PUMP
MULTIPLE DAILY INJECTIONS
YEAR OF DIAGNOSIS: REASON FOR WANTING TO ATTEND THIS CAMP:
WILL YOU BE BRINGING A PARTNER FOR AN EXTRA $150.00 (I.E.HUSBAND/WIFE/BOYFRIEND/GIRLFRIEND) YES
NO
- IF YES, PLEASE ENTER THEIR NAME, DOB, PHONE, EMAIL, SPECIAL DIETS, ALLERGIES/ ILLNESSES/ SPECIAL NEEDS
PAYMENT DETAILS (All successful IF I AM ACCEPTED TO ATTEND CAMP MY METHOD OF PAYMENT WILL BE: applicants will be sent an invoice for CHEQUE/MONEY ORDER CREDIT CARD payment with their camp paperwork) HAVE YOU COMPLETED ALL SECTIONS OF THE FORM?
Scan and email booking form to:
[email protected]
ABN 84 001 363 766 CFN 12458
OR
Mail to: Sydney Weekender GPO Box 9824 Sydney NSW 2001
STREET ADDRESS
POSTAL ADDRESS
26 Arundel Street Glebe NSW 2037
GPO Box 9284 Sydney NSW 2001
Mellissa | 0424 750 207 Ashley | 0433 577 651 HELPLINE | 1300 136 588
PHONE 1300 136 588 diabetesnsw.com.au
