Registration for Little Shadow Group Therapy: Sex, Intimacy & Parenting - 9am Sat 22nd June
Group therapy with Little Shadow, 9-11am Saturday June 22nd 2019
Spaces are limited, you will be invoiced for the $45 cost, your place in the group will be secured with your payment.
We look forward to seeing you.
Email address *
First name *
Your answer
Surname *
Your answer
Phone *
Your answer
Suburb *
Your answer
Do you have any special dietary requirements or allergies? *
Required
Will you need to bring a small person with you? Although we are not able to offer childcare, if you need to bring your under 1yr old, we will do our best to support you and your child as well as the group as a whole, with the aim that the focus stays on the therapeutic aspects of the session and the group as a whole. *
If yes or maybe, how old is your little one?
Your answer
How did you hear about Little Shadow's Group Therapy? *
Required
What other topics of conversation you would like to see us offer?
Your answer
Do you have any questions for us?
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service