Let's start. Registration takes 2 minutes. 

Register Now
 
Where are you attending the program? *


 
Please select the program age group: *

You should select the group based on your child's age. Children MUST be within the ages described below in order to enroll. Please contact us BEFORE registering if you have any questions

 
PARENT DETAILS

Let's start by collecting all your details so we can communicate with you.
 
Parent's First Name *

 
Parent's Last Name *

 
{{answer_xKCa3f4PMFVz}}, what's your mobile number? *

 
CHILD DETAILS

Now, let's complete all the detail about the participant.
 
Child's First Name: *

 
Child's Last Name: *

 
What is {{answer_V0tY7GlgejnI}} gender? *




 
What is{{answer_V0tY7GlgejnI}} date of birth? *

 
And {{answer_V0tY7GlgejnI}}'s age today? *

 
Has {{answer_V0tY7GlgejnI}}received a formal diagnosis? *

For examples, ASD, Anxiety or ADHD?

 
Please provide more details about the diagnosis. *

Please note that the workshop may not be suitable to {{answer_V0tY7GlgejnI}}.
 
Payment and Terms and Conditions

Please take the time to review the terms and conditions as they include non-refund or exchange terms.
 
{{answer_xKCa3f4PMFVz}} please review and agree to the terms and conditions. *

By clicking I accept, you agree to our terms and conditions details available at: http://help.quirkykid.com.au/category/15-billing-terms-and-policies. Our workshops and programs have an additional list of terms available at: http://help.quirkykid.com.au/article/19-terms-and-conditions-workshops
     
 
The total price for the 10-session program {{var_price}} *

The price is $93 per session. This includes all materials, and parent interview and feedback session.
 
Please enter your Credit or Debit Card number: *

 
The CVC number: *

(3 or 4 digit security number on the back of your card)
 
The name on your card: *

 
Your card's expiry month: *


 
Your card's expiry year: *


{{answer_xKCa3f4PMFVz}} well done. {{answer_V0tY7GlgejnI}} is now registered!