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Triple P Registration Form

You're welcome to drop by the office, give us a call, or send an email if you need any help with the referral form.

Multi-line address
Which parenting course are you wanting to register for first? (You can choose another topic after your first course).
Cooperating with Instructions - Teaching our children to listen and follow instructions and helping us manage difficult behaviours
Fears - Supporting our children to overcome fears
Fighting & Aggression – Teaching our children to be kind and get along with others
Bedtime Routines – Supporting our children to develop healthy, independent sleep patterns
Mealtimes – Supporting our children with learning good mealtime habits
Other
Please select all the times that could work for you to attend a course.
9:30am -11:45am
12:15pm - 2:30pm
Other
Would a live Zoom session work for you? (A device with a screen and internet access for 2 hours is needed)
Yes
No
How confident are you feeling about your parenting?
Not at all
Slightly
Moderately
Very
Extremely
How confident are you feeling about your parenting?
Not at all
Slightly
Moderately
Very
Extremely
By submitting this form, you are agreeing to your information being stored securely by ACROSS in our document management system. Records are only accessed for the purpose of providing services, software maintenance, or as legally required.
I understand and consent to what is written above.
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