Registration Form Which programme are you attending? * Cultivating Life Skills (8-17 yrs old) on Wednesdays Young Learners (3-7 yrs old) on Fridays Parent Name * First Name Last Name Phone * (###) ### #### Email * Town where you live * Child 1 Child Name * First Name Last Name Date of birth * MM DD YYYY Any allergies or disabilities? * 2nd sibling Name First Name Last Name Date of birth MM DD YYYY Any allergies or disabilities? **For the Young Learners programme only (age 3 to 7 yrs old) For Young Learners each child must be accompanied by an adult Yes, I am bringing a second sibling 3rd sibling For Young Learners each child must be accompanied by an adult Name First Name Last Name Date of birth MM DD YYYY Any allergies or disabilities? **For the Young Learners programme only (age 3 to 7 yrs old) Yes, I am bringing a third sibling Do you authorise permission to take and share photos of your child/ren on social media to help me promote my programme? * Yes, no problem! Yes, but not the face please No, Thank you Monthly Newsletter Yes, I would like to receive news, upcoming events and insights T&C * I agree to the Terms & Conditions Yes Thank you! We will be in touch with you soon.
