Kids Class Enrolment

First and last name of child. *

First

Last

Child's Date of Birth *

Child's Current Age *

Parent phone number *

Second contact name *

Second contact number *

Select Class *

Term 1 Kids Mosaics Ages 9-12

Do you give permission for your child to be in class photos? *

Yes - artworks and class photos Yes - artwork only No

Would you like information about future classes? *

Yes No

Is your child attending with a friend? *

Yes No Maybe

Friends name *

Does your child have any allergies or learning difficulties that are relevant to their participation in the class? *

Yes No

If yes please provide details and management strategies below. *

Further comments or questions *

Will you be using a Creative Kids Voucher towards payment? *

No Yes - Please enter number below

Voucher Number starting with 9999 *

To use the Creative Kids Voucher at checkout enter the Voucher Code : CK Voucher23