Fear Less Parenting Course Registration Form

Parenting Course Registration Form
Fear Less Triple P

For Anxiety in Children aged 6-16 yrs - 5 Session @ 1.5 hrs
Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Why are you interest in the course (600 words or less)*
Tells us about your situation i.e. wanting to learn more, improve understanding of child development, working with Social Workers, ordered by court etc
What are your top 5 expectations in completing this course? (300 words or less)*
If you have been asked to attend this course via CAMHS/ Court/ Social Worker - please provide any documents or court instructions / relevant documentation *

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Any other relevant information you would like to attach?*

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Course Selection

Programme Choice*

Fear Less Triple P£595.00

Facilitation Option
Item subtotal:£0.00

Premium Service£199.00

up to x3 Support Calls Letter / Report

Total £0.00

Parenting Course Registration Form