Registration – Unlock Your Child's Potential

REGISTER NOW

Register for the Advanced one Day Seminar (March 22nd 2019) or the Unlock Your Child’s Potential two day seminar (March 23rd and 24th 2019)

Which Seminar would you like to register for? (You may choose more than one)

First Name

Last Name

Your phone number

How many participants will be attending?

Are you a Parent or Professional?

If you selected 'other' please specify below...

Child's Name (if Parent or Caregiver)

Child's Age

Diagnosis (if applicable)

Please share some examples of how your child typically communicates

Please share your child's main interests and motivations

What are two or three areas where you would like help and support?

Are you currently running a home program? If yes, for how long have you been doing so and for how many hours per week?

How did you find out about the seminar?