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Year 2011-12
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Pilates Studio
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20 years: 1990-2010
Contact Us
Year 2011-12 > Registration Form
Registration Form
STUDENT DETAILS
Full Name:
Age:
Gender:
Female
Male
Date of Birth:
Mobile:
Home Tel.:
Address:
Email:
Previous experience
(For New Students Only):
Medical History:
SELECTED CLASSES
FAMILY DETAILS
Mother's Name:
Mobile:
Work Tel.:
Occupation:
Email:
Father's Name:
Mobile:
Work Tel.:
Occupation:
Email:
Other Relatives' Name:
Mobile:
Work Tel.:
Other family members attending the School
(Full Name and Class):
OTHER INFORMATION (Please tick accordingly)
I accept to receive announcements through sms & email
I give my approval for the use of photos/video material of
myself
my child
for the School website/printed material
Payment method
Monthly in 9 instalments
Termly in 3 instalments
Yearly in 1 instalment
I accept
the payment regulations
for the defined School year periods
I would like my child to be included in the Group Accident Insurance Plan of the School and I am committed to pay €10 per year, together with the first installment of the tuition fees
HOW DID YOU HEAR ABOUT THE SCHOOL
Friends:
Flyer:
Relatives:
Passing by:
Internet:
Other student:
Name: