Enrolment Form

Child's First Name *
Child's Last Name *
Spoken Languages *
Nationality *
Child's Date of Birth *
Pediatrician *
Pediatrician’s telephone
Allergies *
Are there any health, physical, emotional or behavioral conditions that the teacher should be aware of? This information is used solely to ensure the safety and appropriate care of the child. *

Course registration (Please tick one option)

 *
Course Location *

Personal learning objectives - What are your personal learning goals for your child? This information will help us to set the optimal focus in our future courses (tick 1-2 only):

 *

Please tick if applicable:

The following part only needs to be completed once if there are several children. Contact caregiver 1 *
Last Name *
Preferred Language for communication? *
Telephone *
Email *
Relationship to child *
Caregiver 2
Last Name
Preferred Language for communication?
Telephone
Email
Relationship to child
Billing Address *
Postcode *
City *
Marketing - How did you hear about us? *

Marketing Consent -  We occasionally take photos/videos during activities to share learning moments with parents and to promote Kiducation programmes for marketing materials, including flyers, social media and the website. Kiducation will not publish names or personal details alongside any images nor pass on to third parties. Please indicate your preference.

 *
Where consent has been given, and for children of sufficient maturity 12+, Kiducation will also seek the child’s agreement before using any identifiable photo or video. A child’s preference will always be respected. Consent may be withdrawn at any time in writing.

Declarations and Agreement

 *