Name of parent or guardian *
Name of parent or guardian
Name of child
Name of child
Age of child
Age of child
Phone number
Phone number
Phone number Next of kin
Phone number Next of kin
Which Contakids course are you signing up for?
Logistics !Please note there is a discount for early enrolment! Early bird fee: $100 (registered and paid by June 1 2019) Regular fee: $120 Payment via Pay Pal to https://www.paypal.me/Jollyhue or elijahlee8620@gmail.com Elijah Lee Smith is my Alberquerque friend, he will process your payment You will have your space secured and will receive confirmation as soon as possible. Thank you!
The duty of supervision and liability of the child lies with the parent or guardian (in which case please bring your agreement with parent)