Executive Functions Course Registration Form
Use this form for registering for any EFI course.  Please fill out one form per child being registered. 
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Course being registered for: *
Student First and Last Name *
Student Age (if under 18)
Parent/Guardian #1 First and Last Name *
Parent/Guardian Phone # *
Parent/Guardian #1 email (if student under 18) *
Parent/Guardian #2 First and Last Name *
Parent/Guardian #2 email (if student under 18) *
Student email (if student over 18)
What is your address? *
What are your reasons for registering for this course? What do you or the student hope to gain or learn from the course? *
Has the student had any formal assessments done? If so what assessments have been done? Are you willing to share it with us for programming purposes? *
Does the student have a formal diagnosis? If so, please explain. *
Does the student have any medical conditions, allergies or religious accommodations we need to be made aware of? *
How did you find out about us? *
Do you have any questions? *
Please read through our payment and cancellation policies:

 - Invoices will be emailed and may be paid by etransfer to kelly@devenisheducationalconsulting.com

 - Payment for courses is due in full, upon registration

 - Missed group classes are non-refundable

 - If a class is cancelled due to teacher absence or inclement weather, a make up class will be offered

 - No rescheduling or refunds will be offered if a student is late for a class

Thank you
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