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Name *

First

Last

Phone *

Email *

Number of children to attend *

Child 1 Name *

First

Last

Child 1 Birthdate (MM/DD/YYYY) *

Child 2 Name

First

Last

Child 2 Birthdate (MM/DD/YYYY)

Child 3 Name

First

Last

Child 3 Birthdate (MM/DD/YYYY)

Current grade of child(ren)? *

Where did you hear about us? *

Please let us know where *

What prompted you to explore a new school at this time? *

Is there anything else you would like to share with us?

Phone

1289 Parkdale Drive

Victoria, BC

V9B 4G9

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