Sporting Group Booking Form

Name of club*

Name of club contact*

Contact number*

Email*

Type of sporting group*

Preferred date of program delivery*

Time*

: HH

MM

KIT 1. READ THE PLAY – KNOW WHAT TO SAY?

The focus of this first kit is on getting the necessary conversation about mental health and mental illness started, with games that support young people in knowing what to “SAY”.

KIT 2. READ THE PLAY – KNOW THE WAY!

The second kit looks at using the literacy developed around mental illness to encourage help seeking. The games clearly explain the signs and symptoms of the most prevalent mental illnesses; depression, anxiety and alcohol and other drugs issues. Emphasis is also given to suicide prevention through “Speak up, Speak Out and Protect!”

Selection of kit*

Please Specify which Kit you would like to be delivered; it is an alternating program for example, if your club did Kit 2 in 2013 than they would require Kit 1 to be delivered in 2014. If you are unsure as to which kit your club requires your records will be checked to ensure that the right program is being delivered in your club.

Approximate number of participants*

Name

This field is for validation purposes and should be left unchanged.