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 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 Do you consent to your child having a special treat on special occasions? Yes No Do you consent to Bright Minds using your child’s name, photograph or film for public purposes including social media platforms? Yes No Declaration * I hereby declare that all the information provided to Bright Minds in this application is true and correct. I understand that the purposeful giving of false, misleading or incomplete information may lead to the refusal of acceptance or cancellation of enrolment. I understand the fees and their structure as explained to me. 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
