New Student Registration
Form to register a new student to trial the K.I.C.K - Kids Into Coding Kapiti classes.
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Student's First & Last Name *
Student's School & Year
Parent First & Last Name *
Parent Phone Number *
Parent Email Address *
Any issues KICK should be aware of? (eg severe food allergies, epilepsy, custody issues, etc)
Photos - KICK may take photos, however if child is identifiable, KICK will be in touch if it is to be used in any communications or on social media.
Clear selection
Which classes could potentially fit your timetable?
KICK cannot guarantee availability in all classes or that the class level will be suitable for your student. 
Monday 3:30-4:25pm (Intermediate level)
Monday 4:30-5:25pm
Tuesday 3:30-4:25pm (Waitlist)
Tuesday 4:30-5:25pm
1st Choice
2nd Choice
3rd Choice
4th Choice
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Submit
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