First Name:

Last Name:

Date of Birth:

Sex:

Address:

Postal Address:
(if different from above)

Please enrol my child in:

My first preference for time is: (Click here to see times)

My second preference is:
(if first preference is full)

Days I am unable to come at any time

First Name:

Last name:

Home Telephone:

Mobile Phone:

Work Phone:

Email Address:

Billing Address:
(only fill this out if billing address is different from postal address)

Emergency Contact:

Emergency Telephone:

CARER INFORMATION
(only complete this section if the person bringing you child will be different from the parent. For eg. we have a lot of grandparents and Nannys who bring children on behalf of the parents)

First Name:

Last name:

Home Telephone:

Mobile Phone:

Email Address:

Does your child have special needs?

If yes, what are they?

Does your child have allergies?

If yes, what are they?

Does your child have any difficulty with social or motor skills?

If yes, what are they?

Method of Payment:

How did you hear about us?

RESGISTRATION POLICY

PLEASE READ THE FOLLOWING

1.  We hereby release and agree to indemnify and hold harmless Kids Discover, its educators, employees, liabilities, costs and expenses including solicitor's fees which they or any of them or my child may sustain or incur in any way arising out of my child's participation in any and all Kids Discover activities.

2.  I have read and fully agree with the Registration Policy. No Yes

Please click on the submit button once to send your registration form. A customer service representative will be in touch with your shortly to confirm your registration and organise payment.