Code Rangers Enrolment Form

Welcome to Code Rangers. We're looking forward to meeting you in class! Please complete the details below.

Student Name

First Name

Last Name

Parent Name

First Name

Last Name

Parent Email Address

Contact Telephone Number

Home Address

Post Code

Student School

Student Year at School

Additional Emergency Contact Name

Additional Emergency Contact Number

Second Parent Name (Optional)

First Name

Last Name

Second Parent Email (Optional)

Does your child carry any medication or have any medical conditions we need to be aware of?

How did you hear about us?

Word of mouth

Social media

School newsletter / flyer from school

Time Out

North Shore Times

Own enquiries

Is there anything else you would like to tell us?