1.
Learning for Life Application Form
The following children wish to register for the Tudor House Learning for Life after school care program
FirstName LastName DaysAttending D.O.B. Grade CurrentSchool Gender
Mon/Tue/Wed/Thu Male/Female
Mon/Tue/Wed/Thu Male/Female
Mon/Tue/Wed/Thu Male/Female
Mon/Tue/Wed/Thu Male/Female
Mon/Tue/Wed/Thu Male/Female
PERMISSION
I/We hereby give our permission for my son daughter/ward to attend the Tudor House Learning For Life after school care program and I/we
agree to the Terms and Conditions which apply throughout the time our child/children is/are participating in the program. I/We understand
that acceptance of this form does not constitute admission of our son/daughter.
FATHER / GUARDIAN MOTHER / GUARDIAN
Full Name Full Name
Address Address
Suburb Suburb
Postcode Postcode
Mobile Mobile
Telephone (W) Telephone (W)
Telephone (H) Telephone (H)
Email Email
I/we agree to have the Learning for Life fee charged according to our existing payment structure with Tudor House.
Signature Signature
I give permission for the termly fee to be debited in advance of each term from my credit card as per the fee outlined in the current Schedule of
Fees.
Name on Card Type of Card
Credit Card No. ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Expiry Date
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ /
Signature
Please hand in to the Registrar or email to registrar@tudorhouse.nsw.edu.au PRIVACY STATEMENT – The personal information
collected on this Form is necessary to ensure the
enrolment of a child in the Learning for Life Program. It
will not be used for any other purpose without prior
consent
Where children thrive
Anything else is a compromise
o:general staff share3.administrationlearningforlifebrochurel4l application form 2011.11.30.doc