Enrolment Form

Personal details of student

Surname*
Birthdate*
Gender*
Grade

First Name*
Age*
School Attending

Contact Details of Parent/Guardian

Name and Surname*
Phone number
Choose the SEMAS course*

Choose your SEMAS center*

Email*
Mobile*
Residential Address

Yes, I give permission for my child to have their picture taken and used for marketing purposes

Yes, my child is allowed a lolly after class

Please list any learning/medical/educational concerns your child might have or any difficulties our teachers should
be aware of:

General Details

How did you hear about us?

Internet

News Paper

Ref. by Friend

Facebook

Other

SEMAS T-shirt size (included in the Registration kit)

Tuition fee structure (select one)

- Refer to the Important Notice to view the options

Declaration of Parent/Guardian

I undertake to absolve SEMAS ACADEMY AUSTRALIA and its Centres / Franchisees / Employees / Owners from any claims arising due to injury, loss or damage caused to any child/children or possessions during the period of study, competition, presentation, demonstration.

I have read and understood the Important Notice and rules and regulations governing enrolment and undertake to be responsible at all times for the good conduct and behaviour of myself and my child / children and for all the pending fees. I will not claim for partial/full refund of fees after accepting the courses and signing the Enrolment Form.