College Admissions Form

After School Classes - Art or Science

2026 | TERM FOUR
Programme
Child's Information
Child's Name

First NameMiddle InitialLast Name
Birth Date

DayMonthYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guardian and Emergency Contact
Guardian Name

First NameLast Name
Relationship
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameLast Name
Relationship
Phone
example@example.com
Medical and Other Needs
Does your child have any learning or medical conditions that you would like Te Manawa to be aware of (including allergies). If yes, please specify:
Does your child require assistance to evacuate the building?
Declaration

I declare that to the best of my knowledge the information supplied to Te Manawa in relation to my child/ren attending Te Manawa Learning Activity is true and complete. I agree to abide by the terms and conditions as described as part of the Enrolment Form and process. I acknowledge that I will come into the Te Manawa building to collect my child/ren.
Guardian Name: Date:
Should be Empty:

After School Classes - Art or Science