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Payment form for Therapy Sessions

Thanks for booking therapy sessions with Jump Up for Kids Therapy.

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Please complete the details below, then you will be directed to a secure Stripe payment page when you submit this form. $50 dollars will be deducted from your card now and the remaining balance soon after this.

Please ensure there are sufficient funds available.

 

We require a $50 pre-payment towards the cost of your child’s first session (this amount is credit towards the total session fee cost) or if you need to provide a new credit or debit card (again the $50 will be credit towards any session costs).

 

This debit or credit card will be stored with Stripe and used to pay for additional therapy sessions, assessment services or Outdoors programs you choose to book into.

We will take a $50 booking deposit ($50 session credit) via a secure Stripe hosted payment page to confirm your first session booking or to collect new card details. This debit or credit card will be stored with Stripe and used to pay for the outstanding amount for the first appointment and any follow up consultations (Please ensure sufficient funds are available on debit cards, if not a $10 admin fee will apply):*

 

Price: $50

Total

$ 50.00

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