Child’s name:*

Age*

Gender*

Male

Female

Name of Parent or Guradian*

Mobile phone #*

E-mail (in capital letters)*

Name of the person(s) in charge of pick-up the kid from school:*

First contact person(s) in case of emergency*

Relationship with the kid:*

Mobile phone #*

Second contact person(s) in case of emergency:*

Relationship with the kid:*

Mobile phone #*

Any physical problem to report?*

Yes

If yes, please specify:

Classes

Kids 3-5

Friday 3-5 PM

Kids +6

Saturday 10am - 12pm

Fees

Fees Per Class*

250 ETB / class

800 ETB / month

Password*