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Complete the form below to register

Full name

(Parent/Guardian/Fee Payer)

Student name

Student date of birth (dd/mm/yyyy)

Postage Address

Email address

Phone number

How did you hear about us?

Emergency contact information

Name

Relationship

Contact Number

Emergency contact number needs to remain available whilst the student is participating in Encore Activity

Medical / Injury disclosure

Please detail any medical information we need to be aware of below (including allergies)

If you are not sure your child should be participating in Encore activity please first consult your GP. Any medication left on the premises must be clearly labelled and the student must be able to administer it themselves unless Encore has agreed otherwise in writing.