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Child's name

What Year is your child in?

Parent/guardian name

Parent/guardian email

Parent/guardian phone number

Does your child have any special educational needs? * Required

No

ADHD

Auditory processing disorder

Autism Spectrum Condition

Anxiety

Dyscalculia

Dysgraphia

Dyslexia

Dyspraxia

OCD

other not listed please specify in message box below

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