Play On Class Registration Form (Winter 2023)
Our Winter Classes start the week of January 9th.  
Please complete a separate form for each participant and/or class they will be participating in.  
To complete registration, you will need to send payment (by email transfer to info@playonpediatric.com or call 613-699-0787 with a credit card).  
Once  payment is received, you will receive an intake form through our booking system.  

A caregiver may need to assist the child during the class depending on individual needs. 
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Email *
Child's Full Name  *
Is your child a current client?
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Phone Number *
Date of Birth *
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Class Type (check all the classes that apply for this participant)
*PT Yoga, Core Strengthening and Strength and Conditioning can be claimed through health insurance if your child has an individual Physiotherapy assessment first AND needs this as part of their treatment plan, and no HST is charged.  Otherwise HST will be  charged on the class, and all other classes. 
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Other notes or questions you have about this registration
How did you hear about this class? *
A copy of your responses will be emailed to the address you provided.
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