Freyberg Community School
Freyberg Community Education student Enrolment form - 2012
CHILD'S NAME: .......................................................................................
ADDRESS: ...............................................................................................
CONTACT NUMBERS: (H) ........................ (MOB) .................................
CHILD'S DOB: .........................................................................................
NAME OF PARENT: ................................................................................
EMAIL: .....................................................................................................
1. CLASS ......................................................................TERM ................
DAY & TIME ................................................................. COST ................
2. CLASS ...................................................................... TERM ...............
DAY & TIME ................................................................. COST ................
Visa/Mastercard
Credit card number .................................................................................
Name on Card ............................................................. Exp ....................
I, the undersigned give permission for my child to attend the above
classes. In the event of illness or injury I give permission for medical
attention to be sought knowing I will be contacted as soon as possible.
Signed .......................................................... Date ...................................