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Therapy Registration Form
Student's Details
Parent/Guardian's Details
Home Address
Emergency Contact
Other Details
Parent/Guardian Declaration
I hereby allow my son/daughter as registered above to participate in this activity. I have read the terms and conditions of this activity. I believe that Azon will provide good supervision throughout the activity. I understand that if any unforseen accident happens, Azon shall not bear any legal responsibility.

Payment Methods
1．Cash Payment。
2．Cheque Payment (Payable to)：

Azon Allied Health & Educare Development Sdn Bhd

Submit the cheque at our centre.

E-03-22, IOI Boulevard, Jalan Kenari 5, Bandar Puchong Jaya, 47100 Puchong, Selangor Darul Ehsan.

3．Online Bank Transfer:

Public Bank A/C No: 3239049119

Please Whatsapp the bank-in slip to us.
Mobile No: 019- 297 1431 / 011- 1431 0558
Email: info@azon.my
Website: www.azon.my

Address

E-03-22 IOI Boulevard, Jalan Kenari 5, Bandar Puchong Jaya, 47100 Puchong, Selangor, Malaysia.

Email

info@azon.my

Telephone

Existing/Registered Client Support Hotline
+6(011) 1431 0558

Child Learning & Development Assessment/
Psychological Service Appointment Booking Hotline
+6(019) 297 1431

Service/Event Inquiry，Non-Profit/Charity & Recommendation
+6(019) 231 7154

Certificates and Licenses

Copyright © 2024 Azon Allied Health & Educare Development Sdn. Bhd.
Version 4.5.1.2024.04