ENROL

SUMMER TERM ENROLMENTS CLOSE 22nd JANUARY 2021

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 offer wait list option.

Child 1 Name *

First

Last

Age *

Date of Birth *

Child's Interests *

Special Requirements

Child 2 Name

First

Last

Age

Date of Birth

Child's Interests

Special Requirements

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.
Images of my Child/ren participating in activities at CiA may be shared with others incl. CiA social media.

Parent Name *

First

Last

Email *

Mobile Number *

Postcode *

ENROLMENT FEE - OPTIONS: WEEKLY $65 OR WHOLE TERM $480. PAYMENT SECURES PLACE. FEES MUST BE PAID IN FULL PRIOR TO CHILD ATTENDING THE PROGRAMME *

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 (discount price) 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

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