Registration Portal (Introductory Group Class)

1
Name of parent/guardian* This field is required.
First Name
Last Name
2
Phone number* This field is required.
3
E-mail* This field is required.
example@example.com
4
Learner's name(s)Who is learning?
First Student
Second Student
5
Lesson type* This field is required.group class
[$52] 45-Min Introductory to Inline-Skating for 1 Person (1 session)
[$99] 45-Min Introductory to Inline-Skating for 2 Person (1 session)
[$52] 30-Minute Bike Balancing Introductory Lesson for 1 Child (1 session)
Other
6
Learner's age(s)* This field is required.As of current year
e.g. 5 & 8 (Please indicate a comma if more than one student)
7
Location (Inline)* This field is required.Please select the teaching centre
East Coast Park (Saturday)
West Coast Park (Sunday)
8
Location (Bike)* This field is required.Please select the teaching centre
East Coast Park (Saturday)
West Coast Park (Sunday)
9
East Coast Park (Inline-Skating)* This field is required.Inline-Skating
10
East Coast Park (Bike)* This field is required.Bike-Balancing
11
West Coast Park (Inline)* This field is required.Inline-Skating
12
West Coast Park (Bike)* This field is required.Bike-Balancing
13
Do you have your own training essential??* This field is required.Learners are advised to have a personal set (Wrist, Knee, Elbow, Helmet) - Select what you have only
Helmet
Wrist, Elbow & Knee Pads
Rollerblades
Balancebike
I would like to borrow!
14
Shoe size* This field is required.what is the learner’s shoe size now?
Please Select
Please Select
EUR 24
EUR 26
EUR 28-31
EUR 32-34
EUR 35-36
EUR 38
EUR 40
EUR 42
EUR 44
Size in EUR
15
Is there anything we need to know prior class? (Optional)Please indicate if student requires special assistance
e.g. Past Injury, Medical History, Special Needs, Skin Condition, Allergies
16
Did you hear us from somewhere?* This field is required.
Facebook
Instagram
Google Search
Referral
Others
17
Do you have referral?skip this if NIL
Eg. Jamie (Charlie's mom)
18
Terms & Condition* This field is required.note: Dates requested are not confirmed until a CONFIRMATION message is sent to you via SMS/WhatsApp/Email. Our team will get in touch with you soon! | "LIke" us @ www.facebook.com/littlewheelwerks | TERMS & CONDITION I acknowledge and agree that participating in physical activities comes with inherent risks, therefore students must be responsible for their own safety during urban. | All safety equipment should be worn always during the event. | I undertake to ensure strict compliance with all rules, regulations and instructions given during the Event to minimize risk factors. | Whilst reasonable precaution will be taken by Little Wheel Werks to ensure student’s safety. | I understand that as a participant I take part at my own risk. Little Wheel Werks and their instructors will not be held liable for any injury arising from participating in this event. | I understand that pictures and videos will be taken during event and may be used in social media platform as well as marketing materials. | Little Wheel Werks reserves the rights to reject students who are deemed unfit for class (if undeclared upon registration).
By pressing "Submit" , I AGREE to the above Terms & Conditions
Should be Empty: