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Student information
*
Indicates required field
Child #1 Name
*
First
Last
Child # 1 DOB
*
Child # 1 Sex
*
Female
Male
Child #2 Name (if applicable)
*
First
Last
[object Object]
Child #2 DOB (if applicable)
*
Child #2 Sex (if applicable)
*
Female
Male
If more than two children , please write first name, DOB, sex and group here
*
Nationality
*
What language do you speak at home?
*
School name
*
School year
*
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 information
Parent Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Confirm Email
*
Mobile phone
*
Home Phone (if applicable)
*
Emergency contact
*
First
Last
Medical condition we should know:
*
Emergency Contact Phone Number
*
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
*
How did you hear about us?
*
Friends
Website
Facebook page
Other
If Other, please precise
*
I agree to receiving marketing and promotional materials
Submit
Home
Testimonials
Adults
Become a French Actor
Performances
Pinocchio
Past Performances
Children
French Holiday Program
>
French Background
French Learner
Contact
About us
