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Mind Challenge Booking Form
Book with us.
Student's Surname:
Given Name:
Preferred Name (for name tag)
Gender
Male
Female
Home Phone:
Home Address:
School:
Grade/Year:
Choose three different courses in order of preference
First Preference
Science Works Yrs K, 1 & 2
Art Magic Yrs K,1 & 2
A Dinosaur Adventure Yrs K,1 & 2
Mathemagic Yrs K,1 & 2
Dramatic Imagination Yrs K, 1 & 2
Whales, Sharks and Dolphins Yrs K, 1 & 2
Let’s Build A Castle Yrs K, 1 & 2
Digging Up the Past Yrs 3 & 4
What Lies Beneath? Yrs 3 & 4
Art Works Yrs 3 & 4
Mad About Science Yrs 3 & 4
Sticks, Strings and Gloves Yrs 3 & 4
Drama All Around Yrs 3 & 4
Writer’s Cramp Yrs 3 & 4
Mechanical Creations Yrs 3 & 4
When In Rome Yrs 3 & 4
Explore Creative Drama Like Never Before! Yrs 3, 4, 5 & 6
Digital Animation Yrs 3, 4, 5 & 6
Robotics Yrs 4, 5 & 6
Young Author & Illustrator Yrs 4, 5 & 6
Animal Kingdom Yrs 5 & 6
Brave New Worlds Yrs 5 & 6
Second Preference
Science Works Yrs K, 1 & 2
Art Magic Yrs K, 1 & 2
A Dinosaur Adventure Yrs K, 1 & 2
Mathemagic Yrs K, 1 & 2
Dramatic Imagination Yrs K, 1 & 2
Whales, Sharks and Dolphins Yrs K, 1 & 2
Let’s Build A Castle Yrs K, 1 & 2
Digging Up the Past Yrs 3 & 4
What Lies Beneath? Yrs 3 & 4
Art Works Yrs 3 & 4
Mad About Science Yrs 3 & 4
Sticks, Strings and Gloves Yrs 3 &
Drama All Around Yrs 3 & 4
Writer’s Cramp Yrs 3 & 4
Mechanical Creations Yrs 3 & 4
When In Rome Yrs 3 & 4
Explore Creative Drama Like Never Before! Yrs 3, 4, 5 & 6
Digital Animation Yrs 3, 4, 5 & 6
Robotics Yrs 4, 5 & 6
Young Author & Illustrator Yrs 4, 5 & 6
Animal Kingdom Yrs 5 & 6
Brave New Worlds Yrs 5 & 6
Third Preference
Science Works Yrs K, 1 & 2
Art Magic Yrs K, 1 & 2
A Dinosaur Adventure Yrs K, 1 & 2
Mathemagic Yrs K, 1 & 2
Dramatic Imagination Yrs K, 1 & 2
Whales, Sharks and Dolphins Yrs K, 1 & 2
Let’s Build A Castle Yrs K, 1 & 2
Digging Up the Past Yrs 3 & 4
What Lies Beneath? Yrs 3 & 4
Art Works Yrs 3 & 4
Mad About Science Yrs 3 & 4
Sticks, Strings and Gloves Yrs 3 & 4
Drama All Around Yrs 3 & 4
Writer’s Cramp Yrs 3 & 4
Mechanical Creations Yrs 3 & 4
When In Rome Yrs 3 & 4
Explore Creative Drama Like Never Before! Yrs 3, 4, 5 & 6
Digital Animation Yrs 3, 4, 5 & 6
Robotics Yrs 4, 5 & 6
Young Author & Illustrator Yrs 4, 5 & 6
Animal Kingdom Yrs 5 & 6
Brave New Worlds Yrs 5 & 6
Parent/Guardian's Information
Parent/Guardian's Surname
Parent/Guardian's Given Name
Parent/Guardian's Email
Student's Medical Information
Does the student have any medical conditions?
Yes
No
Medical conditions/allergies
Describe any special care or medication required.
Emergency Contact Person (during the workshop)
Person 1 Name
Person 1 Best Contact Number (mobile preferred)
Person 2 Name
Person 2 Best Contact Number (mobile preferred)
Payment
How would you like to pay?
Pay online
Pay by cheque/money order
Pay by EFT/Direct Deposit