Life Skills Registration | Watermelon Sessions

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Life Skills Cooking Program

Child's First and Last Name*

Guardian's First and Last Name*

Email*

Phone*

Birthday*

Month

Day

Year

I need individual support ($25/h)

How does your child communicate? *

Speaking

Non-Speaking

AAC device

Visuals

Gestures

Please list any allergies

Please list all the triggers:

Please describe de-escalation procedure:

How would you like to pay?*

AFU

E-transfer/credit card

Other

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