Course Registration Form

School of Explorers After School Club

Please complete enquiry form
Childs Details

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parents email
example@example.com
Parents Contact Number
Which session do you require; tick all that apply:

MondayTuesdayWednesdayThursdayFriday
Which School does your child attend?
Should be Empty:

School of Explorers After School Club