Genius R Us

Online Registration

Mandatory *

Surname of Parent / Guardian: *

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Name of Parent / Guardian: *

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Name of Child (1): *

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Date of Birth (1): *

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Date of Birth (1) (month): *

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Date of Birth (1) (day): *

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Name of Child (2):

Date of Birth (2):

Date of Birth (2) (month):

Date of Birth (2) (day):

Name of Child (3):

Date of Birth (3):

Date of Birth (3) (month):

Date of Birth (3) (day):

Address: *

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Postal Code: *

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Contact (HP): *

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Contact (H):

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Contact (O):

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Email Address: *

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How did you get to know us?: *

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What are the courses you would like to register?: Hold Ctrl key to select more than one course

Workshop Details: * Please enter date(s) & time here.

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No. of Adult(s):

No. of Children: *

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Have your been to Genius R Us?: *

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Do you have any package with us?: *

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Terms & Conditions 1) A minimum of 6 participants per class is required for each of the abovementioned workshops to commence 2) Genius R Us reserves the right to reschedule/cancel any of workshop(s) due to unforeseen circumstances 3) All workshop fees are non-refundable but transferable 4) Confirmation of workshop seating(s) is/are upon receipt of payment

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