2020 Twelve and Thirteen Enrolment Form
We are delighted to welcome you to the Twelve and Thirteen Program for 2020. To complete your enrolment we need to collect some important information from you. Please complete all mandatory sections including medical details and complete our behavioural expectation agreement of parents and children. Please note if you have two children participating in the Program, you will need to complete this form twice. (Payment can be made for both children at once).

If you have any questions about the program, please head to www.twelvethirteen.org/faqs. If you require assistance please contact us at hello@twelvethirteen.org.
Please indicate which program you are enrolling in. *
Full name of Child *
Your answer
Full name of Parent/Guardian 1 *
Your answer
Parent/Guardian 1 Email Address *
Your answer
Parent/Guardian 1 Mobile phone number *
Your answer
Please list any allergies your child has (or state none) *
Your answer
Please list any medical conditions your child has (or state none) *
Your answer
Do you give permission for us to use photographs of your child/family for marketing and social media purposes? *
Full name of Parent/Guardian 2
Your answer
Parent/Guardian 2 Email Address
Your answer
Parent/Guardian 2 Mobile phone number
Your answer
Parent/Guardian 1 Residential Address *
Your answer
Child's School in 2020 *
Your answer
Child's Year Level in 2020 *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Is your child partaking in any other Bar/Batmitzvah program? If yes, please list. *
Your answer
How did you hear about Twelve/Thirteen? *
Parent/Guardian 1 Occupation
Your answer
Parent/Guardian 1 Employer
Your answer
Parent/Guardian 2 Occupation
Your answer
Parent/Guardian 2 Employer
Your answer
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