When purchasing tickets for a group, you will be required to provide the following information for EACH of the delegates attending the summit. If you have any questions, please do not hesitate to contact us on support@childtherapysummit.com.au or 0458 703 443.

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*First name

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*Last name

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*Email

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*Pronouns

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Profession?

- Psychologist, Social Worker, Psychotherapist, Counsellor, Creative Arts Therapist, Play Therapist, Occupational Therapist, Speech Therapist or Clinical Manager.

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*Years in profession

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*Organisation Name

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Organisation Status

- GO, NGO, NFP or PP

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Accessibility Requirements

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*Dietary Requirements

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Allergies

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*Consent to be photographed/videoed (delegates will have their name tag indicating their preference and no images will be published without their consent)

- Yes I give my consent

- No I do not give my consent

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*Attending Sundowner or Donating to Charity

- Regrettably I am unable to attend the sundowner please donate on my behalf to Operation Sunshine

- Yes I will be attending the sundowner