Join our Waitlist

Child's Full Name

Child's Date of Birth

Parent/Guardian Full Name

Email

Phone number

Tell us about your child

Does your child have a diagnosis of Autism?

Yes

No

Not Sure

Are you committed to starting right away?

Yes!

No, we are looking for the future

Not sure

Thanks for registering. We will contact you as soon as an opening becomes available.

Waitlist and Registration: Contact

(226) 647-2507

9 Willow St. Waterloo Ontario

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