Registration

Registration

• Today's Date*make a booking
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• Parent / Guardian Name*
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• Address*
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• Home Number*
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• Work Number*full name
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• Mobile Number*full name
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• Email Address*full name
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• Where did you hear about us?*full name
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• Child Details
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• How many children would you like to register?
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• How many children do you have*select number of children1234
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• Child 1 Name*full name
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• Child's Gender
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• Gender*select just one

  Male

  Female
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• Date of Birth*full name
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• What school or preschool does your child attend?*full name
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• Has your child had lessons previously?
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• Has your child had lessons previously?*

  Yes

  No
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• If so, where?*full name
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• Why did you leave?*full name
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• Child 2 name*Child 2 name
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• Child's Gender
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• Gender*select just one

  Male

  Female
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• Date of Birth*full name
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• What school or preschool does your child attend?*full name
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• Has your child had lessons previously?
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• Hobbies*select one or more

  Yes

  No
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• If so, where?*full name
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• Why did you leave?*full name
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• Child 3 Name*full name
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• Child's Gender
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• Gender*select one or more

  Male

  Female
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• Date of Birth*full name
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• What school or preschool does your child attend?*full name
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• Has your child had lessons previously?
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• Hobbies*select one or more

  Yes

  No
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• If so, where?*full name
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• Why did you leave?*full name
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• Child 4 Name*full name
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• Child's Gender
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• Hobbies*select one or more

  Male

  Female
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• Date of Birth*full name
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• What school or preschool does your child attend?*full name
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• Has your child had lessons previously?
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• Hobbies*select one or more

  Yes

  No
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• If so, where?*full name
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• Why did you leave?*full name
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• Medical / Emergency Contact
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• Are there any learning difficulties or medical conditions we should know about?
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• If yes please explain*something more
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• Doctor's Name*full name
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• Doctor's Phone Number*full name
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• Emergency Contact Person*full name
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• Relationship to Student*full name
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• Emergency Contact Numbers*full name
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• Privacy Agreement
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• I have read the Privacy Agreement
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• Hobbies*select one or more

  Yes

  No
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• Submit
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• Email*a valid email address
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