Enrolment

SCHOOL Attended & Current GRADE *

2nd EMERGENCY NAME & MOBILE Number(just in case first Parent can't be contacted) *

DATE OF BIRTH & CHILD'S AGE *

CHILD'S FULL NAME *

ADDRESS(Home/Mailing) *

MESSAGE

ENROLMENT ENQUIRY

PHOTOGRAPHY PERMISSION. From time to time photos and short videos are taken for marketing purposes. No names are ever displayed. *

Yes I give permission.

I would like more information about this.

Please ensure ALL * boxes are completed and click on SUBMIT.

You will then receive a message that we will contact you.

If this form does not disappear please check ALL * BOXES are filled.

How did you hear about KIDS CAN ACT? *

ALLERGIES/MEDICAL CONDITIONS/DIAGNOSIS *

CLASS/WORKSHOP *

Parent's NAME & MOBILE Number *

EMAIL: *