Draw Maths - Registration Form

The information on this form is for the exclusive use of Draw Maths staff. We will not disclose any of this information to any third parties without your permission.

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Registration
I am registering a student for
 *
List of classes
Please tick all the classes you have purchased
 *
Required
1. Student's name *
2. Student's date of birth *
MM
/
DD
/
YYYY
3. Student's gender *
4. Student's preferred pronoun *
5. Student's ethnicity *
6. Student's language spoken at home *
7. Student's level of English
We recommend that students have a minimum level of B1 *
8. Email address that will be used to access the Zoom webinar
Please note that students will not be able to access the online classes using any other email addresses. To change it, please email info@drawmaths.com 
9. Student's current school situation (optional)
Clear selection
10. Student's country of residence
 *
11. Parent or carer's name
(Write N/A is the student is 18+)
 *
12. Parent or carer's relationship with the student
(Write N/A is the student is 18+)
 *
13.  Parent or carer's email address
(Write N/A is the student is 18+)
 *
14. Parent or carer's telephone number
(Write N/A is the student is 18+)
 *
15. Information consent
16. Student's medical Information
Does the student suffer from any medical conditions, which we should be aware of?  Write N/A if not applicable. *
17. Student's Disability and Special Needs
Does the student have special needs (anxiety, OCD, ADHD, autism, Tourette's Syndrome, learning difficulties, etc), which we should be aware of? Write N/A if not applicable. *
18. Photo consent for media and marketing

Do you agree with the following statement?

I agree to the use of images (still or moving) of my child to be used in printed publications, on videos, media releases, on websites, in adverts or social media produced by or for Draw Maths. This form is valid for 2 years. This form is valid for two years from the date of signing. Consent will expire after this. We will not re-use any images after this time. We will NOT include personal details i.e. full names, e-mail addresses, or mobile numbers. I have read and understood the conditions of use above.  
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