Program Enrolment Form

Member's Name *
Member's Name
Member's Date of Birth *
Member's Date of Birth
Parent/Guardians Name *
Parent/Guardians Name
Home Address *
Home Address
Which program/s are you enrolling in?
Help us get to know the member
eg. allergies, conditions...
E.g. use of visuals, sign language e.t.c
E.g. specific strategies for our staff to be aware of
Were you on the look out for a program like this? When did you first hear/see our name?
Media consent *
As the parent/guardian of the member listed above, I give/do not give Active Eight permission to use professional images and video for promotional purposes. This may include; media articles and editorials, A8 website, print material (flyers, posters, etc), social media posts and grant applications.
Subscribe *
Join the A8 emailing list to receive updates, newsletters and other news and events.