Select a Course or Coaching Service from this drop-down Select a Course or Coaching Service from this drop-downKidz Kourse

Select Course Date Select Course DateKidz - June 10 & 11, 2023

Is this child a new student or a graduate? Is this child a new student or a graduate?New StudentGraduate Participant (ANGEL)

Language Preferred in Course Language Preferred in Course English Spanish Both English & Spanish

Who is enrolling the student? Who is enrolling the student? Mother Father Relative Teacher Family Friend

First Name of Primary Contact

Last Name of Primary Contact

Phone of Primary Contact

Email for Primary Contact

First Name of New Student

Last Name of New Student

Age of Student #1

Does this child have siblings? Does this child have siblings? Yes 1 Yes 2 or more No

What is the birth order of the child What is the birth order of the child First Second / Middle Youngest

What is the main reason this child will attend a course or coaching service?

Please add additional information here

Did someone refer you to our coaching services or to our courses? Did someone refer you to our coaching services or to our courses? Yes No

Please let us know who to thank for referral. Please let us know who to thank for referral. Friend Relative School Other

Name of person we can thank for referring you to us