Register Interest for- Ride it out | Hold Steady Counse 1

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Walking with you through life's journey

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First Name

Last Name

Email

Birthday of child

Code

Phone

Has your child previously had therapy, if yes please list

Does your child have a formal ADHD diagnosis?, if Yes when

Which Ride it out program are you interested in ? * Required

ADHD program

Emotional Regulation program

Best time for you * Required

Mornings

School hours- quieter skatepark

After School from 4pm

What is your child's confidence and ability on a skateboard or scooter?

Please review group times and location, please indicate which group you are interested in?

Thanks for submitting!

Suite 3, 34 President Avenue Caringbah

Contact us: info@holdsteadycounselling.com

Phone: 0438245181

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