Enrolment Form BOOK EACH CHILD SEPARATELY if using Active Kids Voucher

Student's Full Name as in Voucher

Student's Date of Birth (DD/MM/YYYY)

If you're claiming a Active Kids Voucher, enter voucher number here

Parent/Guardian Full Name

School Year

School Name

Mother's Email Address

Mother's Mobile Number

Father's Email Address

Father's Mobile Number

Emergency Contact Name

Emergency Contact Mobile

Address

Any significant medical conditions we should know about

How did you come to know about us?

I, give permission to Lotus Yoga Kids to display the image of my child on the Lotus Yoga Kids Website/Facebook/Newsletter and other Promotional Channels. I, give permission to Lotus Yoga Kids to display the image of my child on the Lotus Yoga Kids Website/Facebook/Newsletter and other Promotional Channels. Yes No

Terms and Conditions Terms and Conditions I have read, understood and agree to the terms and conditions of Lotus Yoga Kids. Click here for terms and conditions.

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Enrolment Form **BOOK EACH CHILD SEPARATELY if using Active Kids Voucher**

Enrolment Form BOOK EACH CHILD SEPARATELY if using Active Kids Voucher