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Home
About
Our Team
Our Purpose
Careers
Media
Policies
Therapy
Occupational Therapy
Speech Pathology
Physiotherapy
Psychology
Dietetics & Nutrition
Block Therapy
Telehealth
Online Occupational Therapy
Online Psychology
Online Speech Therapy
Mobile Therapy
Speech Pathology
Occupational Therapy
Programs
Groups
Timetable
Members
Store
Contact
Where Therapy Meets Play
Enquire
Therapy Enquiry
Term Program Enquiry
Holiday Programs Enrolment
Participation Agreement
Yoga Enrolment Form
Member's Name
*
First Name
Last Name
Member's Date of Birth
*
MM
DD
YYYY
Parent/Guardians Name
*
First Name
Last Name
Email
*
Phone Number
*
Home Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
What school/service provider does your child attend?
*
Timeslot (select one or multiple)
*
What is your preferred time slot?
Monday 3:30-4:15pm
Monday 4:30-5:00pm
Has your child ever been involved in an exercise program before, if so which sport/program?
*
Help us get to know your child
What are your child's strengths?
*
Does your child have any medical needs we need to be aware of?
*
eg. allergies, conditions...
Does your child have a communication preference?
*
E.g. use of visuals, sign language e.t.c
Does your child require any support with mobility? If so, what support is required?
*
How can we help to make the program as positive and supportive as possible?
E.g. specific strategies for our staff to be aware of
Is there anything else you believe we should know about your child?
What are your goals for this program?
*
Would you be interested in speaking with our Occupational Therapist about our services?
*
Yes
How did you hear about us?
*
Were you on the look out for a program like this? When did you first hear/see our name?
Media consent
*
As the parent/guardian of the child listed above, I give/do not give The Tippy Toe Co. Incorporated permission to use professional images and video for promotional purposes. This may include; media articles and editorials, TTTC website, print material (flyers, posters, etc), social media posts and grant applications.
Do give
Do not give
Subscribe
*
To the TTTC emailing list to receive updates, the quarterly newsletter and other news and events.
I do want to subscribe
I do not want to subscribe
Thank you, we will be in touch soon!
