Student Registration Parent/Guardian First Name Parent/Guardian Surname Parent/Guardian Phone Number Email Name and Surname (Future Leader) Age of the future leader Gender Male Female Name of the School that the Future Leader goes to What area/suburb do you live in? Media Consent I GIVE my consent for my child’s image to be used on our social pages and website I DO NOT GIVE my consent for my child’s image to be used. The Future Leader will be attending Fridays - In person sessions (Olivedale Library) 15h00pm to 17h00pm Fridays Online sessions (Teams) 17h00pm to 19h00pm Saturdays - In person sessions ( Midrand @Gracepoint Church) 10h00am to 12h00pm Saturdays - In person sessions ( Midrand @Gracepoint Church) 13h00pm to 15h00pm Password Confirm Password Register as Student
