My Teen (ARCHIVED - DO NOT USE) Information - Parent / Guardian 1Name* Full names Last name Phone*Email* Information - Parent / Guardian 2Name Full names Last name PhoneEmail Information - ChildrenNumber of children*1234Name of first child* First Last Age of first child*Gender of first child* Male Female Name of second child* First Last Age of second child*Gender of second child* Male Female Name of third child* First Last Age of third child*Gender of third child* Male Female Name of fourth child* First Last Age of fourth child*Gender of fourth child* Male Female General information requiredSelect which format* Online In person How many seats would you like to book?* 1 seat @ R650 per person 2 seats @ R950 per couple (parents) Preferred language* English Afrikaans Please send me your monthly newsletters* Yes No How did you hear about the "My child's brain" informative talks?CAPTCHA
