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Kodaly Music | Movement | Child-Led
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Seaford Kindergym
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Parent-Child Class Enrolment
SEAFORD KINDERGYM Please complete one form per child. Your enrolment will be based on class availability. You are welcome to contact us to enquire about availability before completing this form, otherwise we will contact you should your chosen day be unavailable.
Child's Name
*
First
Last
Age
*
Date of Birth
*
(dd/mm/yy)
Parent/Guardian's Name
*
First
Last
Mobile Phone Number
*
Home or Work Phone Number
E-mail
*
Day of week preference for Seaford Kindergym?
*
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
Alternative Day Availability
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
(In case your preferred day is fully booked)
What date/week would you like to commence classes?
Please note: Seaford Classes run from 1st day of school year (usually mid-late January) through until last day (usually mid-Dec) with no school term breaks.
Emergency Contact
*
First
Last
Emergency Contact Phone Number
*
Emergency Contact Relationship
Does your child have any allergies, medical conditions, challenges or sensitivities that we should be aware of?
*
(Please note: you will be required to complete a Medical Form at your first class)
Has your child been immunised as per the National Immunisation Program Schedule?
*
YES - Please bring a copy of your Child's Immunisation Record with you to class
NO - We will contact you to discuss further
Do you consent to your child being photographed?
*
YES
NO
(Please note: more information is provided on our Photography Consent Form to be completed at your first class should you choose to consent)
Lastly, how did you hear about us?
*
Email
Submit