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* 1. Your Child's Full Name

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* 2. Your Child's Date of Birth

Date

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* 3. Parent/ Guardian's Name

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* 4. Contact Email Address

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* 5. Contact Phone Number

Enrolment Preferences

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* 6. Which program would you like to enrol in?

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* 7. Which day would you prefer?

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* 8. How did you hear about Flourish? (If friend, please let us know who so we can thank them)

Thank you so much for your interest in enrolling in one of our programs - we’ll be in touch within 48 hours. In the meantime, please add our email address to your contacts to ensure our messages don’t land in junk mail (we’d hate for you to miss out if a place becomes available).

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