Aquatic Therapy

Aquatic Therapy - Registration of Interest

Autism Association of South Australia trading as Autism SA, ABN: 98 164 545 215

PO Box 304 Marleston DC SA 5033

P. (08) 8379 6976, F. (08) 8338 1216, W. www.autismsa.org.au

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Please fill out your registration of interest in our Aquatic Therapy Program below. Once received, you will be sent an email with further information.

Your Name: *

Client Name: *

Client Date of Birth: *

Client Suburb: *

E-Mail Address: *

Best contact number: *