GHA Dementia Wellness Workshop - Booking Request Form

Thank you for your interest in our GHA Dementia Wellness Workshop, as part of the Northern Beaches Council 2025 Seniors Festival. Please complete the booking request form below and we will be in touch as soon as possible to confirm your spot.

GHA Dementia Wellness Workshop

When: 12.00-3.00pm, Wednesday 19 March, 2025

Where: Queenscliff Surf Life Saving Club

First Name

Last Name

Email Address

Contact Phone Number

Will anyone else be attending with you?

Yes (please confirm how many and their names below)No

If yes, how many people will be joining you?

If yes, please share the names of those joining you below.

Please let us know if you have any dietary requirements:

Please share with us what you are hoping to gain or take away from the session: