Three for Three Immersion Registration
Three For Three Immersion
3 days. 3 lessons/day

Nine - 25 Minute NeuroMovement® Lessons
One location
Two NeuroMovement® Professionals
Follow-up consultation
Cost $750

3 families will be accepted for each Three for Three Immersion after completing the registration and submitting a deposit to hold the space.

A wait list will be created based on registration submission order.
OPTION A: May 11, 12 14, (Monday / Tuesday / Thursday)
OPTION B: May 13-15 (Wednesday / Thursday / Friday)
I am interested in registering for:
Name of Parent/Guardian (First and Last) *
Your answer
Email *
Your answer
Phone #: *
Your answer
Participant Information:
Please help us "get to know" your child.
If you are a returning participant, please let us know how your child has changed and provide any updates.
Name of Participant (first and last) *
Your answer
Date of Birth of Participant: *
Your answer
Brief general description of diagnosis:
Your answer
Please tell us what your child CAN do currently if applicable (i.e. crawling/reaching/counting)
Your answer
What outcome/s would you hope for from the Three for Three Immersion?
Your answer
What other therapies/modalities/devices does your child use or participate in currently
Please list any equipment/devices your child uses regularly
Your answer
Thank you!
Kathy from MoveAbilities LLC or Phoebe from Brilliant Movement LLC will contact you shortly after receiving your registration request outlining deposit payment information. Your deposit of $100 secures your place in our Three for Three Immersion.

When all slots are filled we will create a wait list for any spots that come available. Your deposit is non refundable unless another child from our waitlist can fill that slot.

If you have any questions, you can email Kathy and Phoebe at one convenient email:
ABMNorthWest@gmail.com

We look forward to connecting with you!

THANK YOU
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