ENROL

NEW ENROLMENTS OPENING SOON!
PRE-REGISTER YOUR INTEREST for
TERM 2, 2021 here

Please COMPLETE & SEND this form to register your interest* to enrol your Child/ren the CHILDREN’S IMAGINATION ACADEMY (CiA) ONE DAY PROGRAMME

*We will make contact to confirm placement or wait list option.

Child 1 Name *

First

Last

Age *

Date of Birth *

Child's Interests *

Behavioural Support Requirements/ Medical Conditions / Additional Info About Child?

Child 2 Name

First

Last

Age

Date of Birth

Child's Interests

Behavioural Support Requirements / Medical Conditions / Additional Info About Child?

Parental Permission (please tick) *

My Child/ren can participate fully in all activities and workshops offered at the CiA Programme.
My Child/ren can go on regular visits to the Community Gardens and all nature/outdoors excursions.
I give permission for pictures of my child participating in activities to be shared on social channels and parents emails.

Parent Name *

First

Last

Email *

Mobile Number *

Postcode *

ENROLMENT FEE - OPTIONS PER CHILD: WEEKLY $65, 2 x TERM $260 OR WHOLE TERM $520. PAYMENT SECURES PLACE. FEES MUST BE PAID IN FULL PRIOR TO CHILD ATTENDING THE PROGRAMME AND ARE NON-REFUNDABLE. *

I choose to pay WEEKLY $65 p/session and understand payment secures my Child/ren's place at the Children's Imagination Academy.
I choose to pay 2 x TERM installments $260 each and understand payment secures my Child/ren's place at the Children's Imagination Academy.
I choose to pay WHOLE TERM $480 (CURRENT DISCOUNT RATE/ Save $40!) and understand payment secures my Child/ren's place at the Children's Imagination Academy.

How did you find out about the Children's Imagination Academy? *

Please specify

Additional Notes

Name

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