Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Student's name *FirstLastStudent's date of birth *MM/DD/YYYYStudent's current School Name *What grade is your child? *Does your child have any allergies, medical conditions, or specific learning needs? *Parent/Guardian Name *FirstLastParent/Guardian Email *Parent/Guardian Phone *Parent/Guardian Home Adress: *Which class do you want to register for? *What are your expectations from our classes? *How did you hear about us?InstagramFacebookFriend/FamilySchoolOther Parent/Guardian What Name Consent & Media ReleaseI give permission for VanMind Academy to take photos and/or videos of my child during classes for promotional use on social media and marketing materials.Permission & Agreement *I agree and give my permissionI give permission for the student named above to participate in the course(s) I am registering them for at VanMind Academy. Submit
