ICAN Academy Registration Form.

Person submitting the form:

Name:

Students details:

Students Name:
Date of Birth:

Parent / Guardian details:

Parents / Guardians name:
Address:
Email:
Phone:

School / Organisation details:

School / Organisation name:
Teacher / SENCO / Caregiver:
Email:
Organisation phone:
Support required:
If supported, please provide details of the support the student will come to class with:
Medical information: (please provide detailed information of  student disabilities and medical information that we need to be aware of)

Emergency contact details: 

In the event of an emergency or medical event that involves the student during a ICAN performance class, please clearly state the name and phone number of the person to contact

Name:
Phone:

Billing details:

Please select who accounts will be sent to:

Terms and Conditions:

STUDENT SUPPORT: It is the joint responsibility of the caregivers, school and organisation involved with the student to ensure that they come to the class with the level of support they require to particulate fully and safely. If the student is not supported as detailed in the registration form, the teacher has the right to immediately exclude them from the class in action. At any time if the teacher feels that enrolled student becomes a risk to the safety of other staff member or participating students, they have to right to exclude the enrolled student from the class immediately.

NON ATTENDANCE: If a student is unable to attend a lesson due to illness or another commitment the Class Teacher must be notified before the lesson. Non-notified unattended lessons will be charge for. 

INVOICING: An account for classes attended will be sent to the registered billing address at the end of each month. The Account is payable by the 20th of the following month. Fees are paid directly to Giant Leaps Speech Company.

PUBLIC HOLIDAYS: Classes will not be held on Public Holidays

DISCONTINUING CLASSES: If a student wished to discontinue with classes, 2 WEEKS WRITTEN NOTICE is required from the caregiver / school / organisation.  The student will continue to be charged until the notice is received.

Agreement: