ENROL

We’re so excited to join you on your Chill journey!

For new participants:

  1. Fully complete the form below
  2. On receipt of your form we will make contact to arrange an enrolment meeting.
  3. During the meeting you will be advised of program suitability and availability.

For returning participants:

  1. Fully complete the form below
  2. On receipt of your form we will make contact to advise of a place/s in your chosen programs.

*Enrolments for Term 4 have closed. We are now enrolling new families for Term 1, 2021 in-person programs only. Keep an eye on your email for 2022 enrolment updates coming soon!

If you would prefer to fill these forms out as a PDF, please click on the form that best describes you below, complete in full and email to admin@codeblueforautism.com.au

    I am a...

    About you

    What do you like doing?
    What do your family and friends say you are good at?
    Who is important to you like your life?
    If you could do anything in your life right now, what would it be?
    What do you currently spend your time doing during the week? Tick all that apply
    StudyVolunteeringWorkOther (please provide details)
    What do you like to do on weekends?
    What sort of things would you like to learn at Chill? Be as specific as possible!

    Chill programs

    Read more about the Chill Foundation program

    Cost

    $1,750.00 per term (10 weeks)

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Mondays 10:00am – 12:30pmMondays 2:00pm – 4:30pmTuesdays 10:00am – 12:30pm

    Read more about the Chill Tunes program

    Cost

    $1,450.00 per term (10 weeks)

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Mondays 2:00pm – 3:30pm

    Read more about the Chill on the Grill program

    Cost

    $1,500.00 per term (10 weeks) 1:3 Zoom support
    $2,800.00 per term (10 weeks) with 1:1 support

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Tuesdays 10:00am – 12:30pm

    Choose support option

    1:1 mentor support in your home (limited availablity)1:3 mentor support via Zoom online

    Read more about the Chill Art program

    Cost

    $1,800.00 per term (10 weeks)

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Tuesdays 10:00am – 12:30pmTuesdays 2:00pm – 4:30pm

    Read more about the Chill Money program

    Cost

    $3,600.00 per semester (20 weeks)
    $5,120.00 per semester (20 weeks) with 1:1 peer mentor support

    2021 Semester

    Semester 1 2022: 24 January – 24 June

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Wednesdays 10:00am – 12:30pm

    Read more about the Chill Plus program

    A prerequisite to the Chill Plus program is being enrolled in, or completion of the Chill Foundation program

    Cost

    $1,750.00 per term (10 weeks)

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Wednesdays 12:30pm – 3:00pmWednesdays 2:00pm – 4:30pmThursdays 10:00am – 12:30pmThursdays 2:00pm – 4:30pm

    Read more about the Chill Sport program

    Cost

    $1,600.00 per term (10 weeks)

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Thursdays 10:00am – 12:00pm

    Read more about the Chill on Stage program

    Cost

    $1,650.00 per term (10 weeks)

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Fridays 10:00am – 12:30pm

    Read more about the Chill Write program

    Cost

    $1,650.00 per term (10 weeks)
    $2,410.00 per term (10 weeks) with 1:1 peer mentor support

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Fridays 2:00pm – 4:30pm

    Read more about the Chill Moves program

    Cost

    $1,400.00 per term (10 weeks)

    2021 Term

    Term 1 2022: 24 January – 1 April

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Wednesdays 4:30pm – 6:00pm

    Read more about the Chill Life program

    Cost

    $3,770.00 per semester (20 weeks)

    2021 Semester

    Semester 1 2022: 24 January – 24 June

    Preferred workshop time

    Please note: the workshop time you choose may not be available. This will be confirmed in your enrolment meeting.

    Mondays 10:00am – 12:30pm


    Participant details


    MaleFemaleOther

    Parent/carer details


    ParentCarerGuardianOther

    Emergency contact

    Same as aboveDifferent to above


    ParentCarerGuardianOther

    Weekly updates

    Weekly updates will be emailed to:

    Chill participantParent/carer


    Have you been referred to the Chill program(s) from a healthcare professional or disability service provider?

    YesNo

    Please provide the referrer's details

    Has the participant received a formal diagnosis of ASD?

    Year of diagnosis?


    Medical information

    You are required to complete this section fully even if you have completed it in previous terms


    YesNo

    Please list the medications and dosages you are currently taking


    YesNo

    Please list your allergies


    Your NDIS plan

    Code Blue for Autism is a registered provider with the NDIS (National Disability Insurance Scheme).

    Code Blue for Autism’s NDIS provider registration number is: 405 000 321 11. Chill programs are registered under the following support categories:
    0125 Participate Community, 0117 Development Life Skills, 0115 Daily Tasks/Shared Living, 0106 Assist Life-Stage, Transition


    YesNo

    Please provide the goals as outlined in your NDIS plan. You must enter your NDIS goals exactly as they are stated in your NDIS place. We cannot process your enrolment is the appropriate goals are not provided eg.'Same as previous term', 'Life skills', 'Friendships' etc.

    Self-managedPlan-managed (you have engaged someone to manage your invoices and payments)NDIA-managed (agency-managed)

    If your NDIS plan is plan managed please provide the following details:
    Please provide the following details about your NDIS LAC (local area coordinator)
    If you have a support coordinator please provide the following details:

    Terms and conditions

    Please read carefully before submitting

    1. Requirements

    These are the minimal requirements for participation in the Chill Program:

    Self-Management
    Participants must be able to attend to basic self-care to include dressing and toileting.

    Behaviour
    Participants must be able to self-regulate emotions and behaviours in a group setting.

    Communication
    Participants must be able to express needs and understand instructions.

    Ability to Follow Program Rules
    Participants must be prepared to follow some basic rules whilst engaged in the Chill Program. These include: no use of mobiles during the workshops and showing respect to all fellow participants.

    Participation
    Participants must be willing to “have a go” and actively participate in the program. Participation is crucial for skill acquisition and improvement. Non-participation significantly affects group dynamics and is a mandatory requirement that each enrolled individual participate to the best of their ability.

    The CEO (or delegate) of Code Blue for Autism has the right to withdraw an individual from any of the Chill programs if they are not able to meet any of the above minimal requirements when engaged in a workshop. In this instance, the program fee is non-refundable.

    2. Expectations

    The purpose of the Chill programs is to:

    • Help young adults learn how to develop and maintain friendships and relationships, and handle peer conflict and rejection
    • Teach ecologically valid social skills that are used by socially successful adults.
    • Help young adults to find a source of friends
    • Provide young adults with peer support through social coaching
    • Ultimately help young adults foster independence in social relationships

    Please note: Chill is not an autism support group or a friendship-matching group. In order to maximize optimal outcomes from the Chill program, the participant must:

    • Attend every session on time
    • Actively engage in all workshop activities
    • Practise/generalize the newly learnt skills outside of the program setting

    3. Fee payment

    Fee payment is required in full prior to commencement of the program term.

    If you have an NDIS plan and are:

    Self-Managed
    You can claim your term fee from your package before commencement of term (provided you have a service agreement with Code Blue)

    Plan-Managed
    You and your plan manager will receive a service agreement and invoice.
    Your plan manager will contact you to approve payment of the invoice.
    Your plan manager will make payment to Code Blue on your behalf.
    If your plan manager does not pay for term fees up front you may have to pay for the fees personally and then be reimbursed by your plan manager.

    NDIA-Managed
    By providing your NDIS plan details, Code Blue will be able to make a service booking and a payment request online to the NDIS in order for your term fees to be paid.

    4. Program fees

    Chill Foundation $1,750.00 per term (10 weeks)
    Chill Tunes $1,450.00 per term (10 weeks)
    Chill Plus $1,750.00 per term (10 weeks)
    Chill Money $3,600.00 per semester (20 weeks) OR $5,120.00 per semester (20 weeks) with 1:1 peer mentor support
    Chill on the Grill $1,500.00 per term (10 weeks) OR $2,800.00 per term (10 weeks) with 1:1 in home support
    Chill on Stage $1,650.00 per term (10 weeks)
    Chill Art $1,800.00 per term (10 weeks)
    Chill Moves $1,400.00 per term (10 weeks)
    Chill Write $1,650.00 per term (10 weeks) OR $2,410.00 per term (10 weeks) with 1:1 peer mentor support
    Chill Life $3,770 per semester (20 weeks)
    Chill Sport $1,600 per term (10 weeks)

    5. Cancellation policy

    A participant may cancel their enrolment and be refunded the full program fee provided two (2) weeks notice (prior to commencement date of the term) is given. Due to the nature of the program, and the amount of individualised preparation required prior to term commencement, the program fee is non-refundable if the above notice has not been given. Should the participant commence the program and decide to withdraw, the total program fee is non-refundable.

    6. Getting started

    Prior to commencement of the program you will receive a Getting Started email that will provide you with information about our program facilitators, peer mentors, and what to expect at the first workshop. On receipt of this pack please do not hesitate to contact us if you have any questions. Thank-you for your enrolment. We welcome you to the Chill family.


    Acceptance of the terms



    By electronically entering your name below, you agree to all terms and conditions stated in this form.

    Privacy

    All personal information collected by Code Blue for Autism is done so exclusively with your consent. The personal information collected is only used by Code Blue for Autism staff for the purposes defined at the time of the collection or a use that complies with these purposes. We do not share your information with any third parties.