After School Program Registration Form. 2023/2024
Thanks for your interest in our services.
Please complete the registration form and kindly read our Terms and Conditions.
https://tinyurl.com/C-T-termsandconditions
If you have any questions, do not hesitate to contact us at
[email protected]
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Parent's /Guardian's First Name
Parent's/ Guardian's Last Name
Email
Confirm Email
Mobile Phone
Additional contact/Parent (Name and phone)
Home Address
I have read and I accept Ceibo Tutoring's Terms and Conditions
How did you hear about us?
Student
First Name
Last Name
Date of Birth
Age
School
Does your child have Special Education Needs?
Yes
No
Diagnose
Allergies/Medical Info
Remove
Add Fields for Additional Student
Submit
