AFEP Samurai Children/Youth: Enrollment Form
The information in this form will ensure the AFEP caters to the individual needs of the participant contributing to best outcomes. This information is held in strict confidence and will adhere to our privacy policy.
*Required Fields.
Birthday of Child Participant*
Has the Pre-Admission Assessment Been Completed?*
Does the Child Participant Have Siblings?*
Does the Child Participant Have 2 Parents Living in the Same Household?*
Is the Child Participant currently Under Care of a Physician for Ongoing mental and/or Physical Health Concerns?*
Is the Participant Under Disciplinary Action by Either School or Law Enforcement? *
Has the Participant been Expelled from School or Sports Club?*
Non-Refundable Payment Which will be Deducted from 1st Months Fees.
$15
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