Online Registration

FREE Parenting Teens Virtual Workshop
2022 Workshop will be announced

Facilitated by Dr Dee - Clinical Psychologist Akeso Crescent Clinic
Randburg, Johannesburg, South Africa

Upon submission you will receive confirmation of your free registration.

1. Delegates Information
Title:	Please select Prof Dr Mr Mrs Ms Miss
Full names:
Marital status:	Please select Married Single never married Divorced Widow
Contact no.:
Alternative contact:
Email address:
Physical address:
Highest level of education:
Occupation:
Relationship to teenage child:
2. Teenage Child’s details
Age:
Gender:
Birth order in family:
Grade:
School name:
3. Documents required with registration: Please email to info@parentingteens.co.za
Proof of residence:	Please select Yes No
ID certified copy (less than a month):	Please select Yes No
Copy of the medical aid card for participants whose sessions will be claimed from medical aid:	Please select Yes No
Kindly note that when claiming through medical aid, you are still liable to pay for the levy amount upfront for the four sessions if there is a discrepancy between the workshop fee and the rate paid by the medical aid. Please note that you will not qualify for the early bird special rate
Please retype the code above?

.

.