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The Hullabaloo Social Skills Group Registration (5-8)
1.
Child's Name: (First Name, Last Name)
2.
Date of Birth: (mm/dd/yyyy)
3.
Parent's Name: (First Name, Last Name)
4.
Contact Number:
5.
Email Address:
6.
Which group(s) are you interested in? Please select all that apply.
The Discovery Club
Little Makers
Athlete Academy
7.
Goals you want your child to learn in a social setting.
8.
Does your child communicate their wants and needs effectively?
Yes
No
9.
Is your child interested in interacting with other children?
Yes
No
10.
Does your child engaged in challenging behaviour?
Yes
No
If yes, (please specify)