SCHOOL READINESS REGISTRATION FORM Child's Name * First Name Last Name Child's Birth Date * MM DD YYYY Address Address 1 Address 2 City State/Province Zip/Postal Code Country What year does your child start Kindergarten? * Parent/Guardian Name * First Name Last Name Relation to Child? * Email * Phone (###) ### #### Emergency Contact (Other than parent) * First Name Last Name Relation to Child? * Number What is your child's best available days and times? * Please select all available days and times and we will try our best to allocate your child a session that best suits them. Monday 10-11:30am Monday 1-2:30pm Tuesday 10-11:30am Tuesday 1-2:30pm Wednesday 10-11:30am Wednesday 1-2:30pm Thursday 10:30-12pm Thursday 1-2:30pm Friday 10-11:30am Friday 1-2:30pm Is your child toilet trained? * Yes No Does your child have any medical conditions, learning impediments, allergies, dietary concerns? * Yes No If yes, please provide details Declaration * I agree to Bright Minds terms and conditions, a copy of these terms and conditions can be found below. Thank you! ENROLMENT FORMPlease fill out your details below. Terms and Conditions
