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The Zokha Autism Developemental Center
The Zokha Autism Developemental Center
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Sensory Play Day Registration
Parent/Gaurdian Name *
Email Address *
Phone Number *
Child's Name *
Child's Age *
Does your child have sensory sensitivities or special needs? *
Yes
No
Bake Box Preorder (Optional) *
No
$40 Standard Bake Box
$60 Support Bake Box
Registration Type *
35$ - Single Child
60$ - Sibling Pair
Preferred Time Slot *
1 PM
2 PM
3 PM
Leave this field empty
Submit form
Payment must be made to secure your child's spot.
Payment Secured by Stripe below:
Sensory Play Day Registration - 1 Child ($35)
Sensory Play Day Registration - Sibling Pair ($60)
