AIM Summer School 3 Monthly Payments Parent or Contact Details * First Name Last Name Email * Mobile Number * (###) ### #### Landline Number * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Child's Name * If you would like to enrol more than one child please submit a second form First Name Last Name DOB * MM DD YYYY Medical Notes * Child Preferred Name * Emergency Contact Name * Emergency Contact Number * (###) ### #### Emergency Contact Relationship to Child * Consent for First Aid * Yes No Consent for Photos We take photos of the class in action and post on our AIM Facebook account and website from time to time , we will always ask for your permission first. Yes No Thank you!
