Enrolment Form

Student First Name

Student Last Name

Parents First Name

Parents Last 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

Select Courses Select Courses English and Math Course Coding and Robotics Course Mental Math Abacus Kids Yoga Course (in Quakers Hill) Hindi Course (in Quakers Hill)

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Any significant medical conditions we should know about

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I, give permission to Learners Academy* to display the image of my child on the Learners Academy* Website/Facebook/Newsletter and other Promotional Channels. *Learners Academy includes Study Champs Tutoring, Logical Coders, Lotus Yoga Kids and Memory Abacus Lab. I, give permission to Learners Academy* to display the image of my child on the Learners Academy* Website/Facebook/Newsletter and other Promotional Channels. *Learners Academy includes Study Champs Tutoring, Logical Coders, Lotus Yoga Kids and Memory Abacus Lab. Yes No

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