Registration Now Open - Kid Mechanix - Getting Social Starts Here!

Virtual and In-Person Programs

Registration is OPEN for social skills classes, school readiness programs, small group instruction, parent coaching, and individualized ABA sessions.

Follow these 3 easy steps:

1. Contact our Program Director to determine program suitability.

2. Schedule a free intake assessment.

3. Fill out our secure online registration package (below) and read the Policies and Procedures (click here)

Child's First Name

Child's Last Name

Primary Phone Number

Secondary Phone Number

Primary Email

Secondary Email

Primary Address (number and street name)

Postal Code

Other Address (if applicable)

City

Parent/Caregiver Name

Custodial Parent

Emergency Contact Name

Emergency Contact Phone Number

Child's Gender

Child's Date of Birth

Diagnosis (Leave blank if n/a)

Date of Diagnosis

Siblings (including first name + age). Leave blank if not applicable

Child's School

Child's Grade Level

EA Support?

Allergies (put n/a if none)

Food Sensitivities (put n/a if none)

Medications (put n/a if none)

Primary Doctor

Doctor's Phone Number

Doctor's Address

OHIP Number

Approved Pick Up (please list name and relation, separate with commas)

Who is able to pick up my child from Kid Mechanix.

Please list your goals here. Be as specific as possible.

Please describe your child's communication skills (e.g., uses 3-4 word phrases, uses gestures to communicate, uses some sounds, AAC user, etc.). Be as specific as possible.

Please describe your child's play skills, preferred toys, and leisure activities.

Please describe any challenging behaviour's your child engages in. Be as specific as possible.

What is likely to trigger episodes of challenging behaviour? Describe what happens for challenging behaviour to stop.

Please describe any of your child's dislikes. Be as specific as possible.

Credit Card Number

Expiration Date

CVC

Comments

Please read and review the Policies and Procedures before submitting.
Click here to access the Policies and Procedures.