ESA COMPANY STREAM REGISTRATION

EPIC STUDIOS AUSTRALIA

Preschool Registration Form
Student Details
Student Name*

First NameLast Name
Student DOB*

DayMonthYear
Date
2023 Age Group*
Allergies/ Medical Information*

Parent/ Guardian Information
Parent 1 Full Name*

First NameLast Name
Parent 2 Full Name (if applicable)

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact - must be different to parent/s listed above*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number

Registration Confirmation
By submitting this form you acknowledge that you have read and agree to all of ESA's Information, Enrolment Policies & Terms & Conditions as outlined in the preschool prospectus including but not limited to:

- Class Fees & Payment

- Class Requirements/ Uniforms

- Cancellations

- Code of Conduct

and more
Parent Signature

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ENROLMENT FEE*

ESA ENROLMENT FEE Product Image

ESA ENROLMENT FEEEnter description

$44.00AUD Quantity
Item subtotal:$0.00AUD

Total

$0.00AUD

Credit Card

Should be Empty: