FHP-Enrolment-BACKGROUND-RETURNING

Student information

* Indicates required field

Child #1 Name *

First

Last

Child # 1 DOB *

Child #2 Name (if applicable) *

First

Last

[object Object]

Child #2 DOB (if applicable) *

If more than two children , please write first name, DOB & Groupe here *

Please, choose one or more options *

11 to 15 of July 2022 - North Perth 3 to 7 of Oct 2022 - North PERTH

Early drop off 8:30am and late pick up 4pm ($50+gst for the 5 days) *

Yes No Not decided yet

Parent Name *

First

Last

Address (if changed since last time you enrolled) *

Line 1

Line 2

City

State

Zip Code

Country

Email (if new) *

Mobile phone (if new) *

Emergency contact (if new) *

First

Last

Emergency Contact Phone Number (if new) *

Medical condition we should know (if new): *

Permission to use photography *

Yes No Under some conditions

When you click yes you allow us to use photography for publicity purposes: website, facebook page, press.

If Under some conditions, please precise. *

Please tick *

I understand that I have to pay $55 of annual administration fee per family. I understand that I have to pay fees before class.

Date *

I agree to receiving marketing and promotional materials

Submit

We acknowledge that we are living on Aboriginal land.
We pay respect to the First People of this country.
We love to learn from their dreams.