Enrollment-form-old-bkp-171023

Province*

Details of the Child

First Name*

Last Name*

Date of Birth*

Gender*

Street*

Unit/Apt No

City*

Province*

Postal code*

Primary Phone Number*(Country Code not required for Residents of Canada & US)

Studying in Grade*

Name of the School

Details of the Parents

Mother’s Name*

Father’s Name*

Mother’s Cell*(Country Code not required for Residents of Canada & US)

Father’s Cell*(Country Code not required for Residents of Canada & US)

Email address 1*

Email address 2

General Details

How did you hear about i-Maths?*

Preferred days*

Preferred timings

Emergency contacts (by priority)

Name*

Tel*(Country Code not required for Residents of Canada & US)

Authorized individuals to pick up student

Name*

Relation*

Medical Details

Health card number :

If your child has special conditions/Allergies/Medication, please provide details:

Enrolment Agreement

A non-refundable registration fee is required at the time of registration.
Two months notice or fee in lieu of, required for any withdrawals.
If i-Maths requires the withdrawal of a student, a refund will be given in proportion to the part of the course.
There will be no discount or refund of course fees for any leave of absence during the term of the course.
The course fees does not include the March Break Camp or Summer Camp programs.
Any cheques returned NSF will incur a $25 service charge. Payments not received by the due date will incur late payment charges.

Some of the i-Maths material involves small parts. Parents are advised to supervise the activities of their children when handling i-Maths material at home. You agree that i-Maths Canada and/or its principals will not be held liable for injuries, claims or damages arising out of improper use or improper supervision at home.

We realize that even under close supervision, children may have occasional accidents. Therefore, we hereby release for indemnity and hold i-Maths Canada, its agents /franchisees, and employees harmless from any and all claims, damages or other liabilities for injuries to my child which are not a result of direct negligence of the staff.

We grant permission to the authorities at i-Maths Canada to use photographs and visual recordings of my child taken in the i-Maths centre and any event organized by i-Maths Canada, provided no identification (name or address) will be used unless explicitly authorized.

We, the undersigned, do hereby represent that all statements made by us on the Student Registration Form are correct, and we acknowledge that we have read, understood and agree to all terms and conditions of the registration, as set forth in the form.

I agree