OBotz Enrollment Form

Details of the Child

First Name*

Last Name*

Date of Birth*

Gender*

Street*

Unit/Apt No*

City*

State*

Zip Code*

Primary Mobile Number*

Studying in Grade*

Name of the School*

Details of the Parents

Mother’s Name*

Father’s Name*

Mother’s Mobile Number* (Country Code not required for residents of Canada & USA)

Father’s Mobile Number* (Country Code not required for residents of Canada & USA)

Email Address 1*

Email Address 2

General Details

First Name (Student Who Referred the Program) *

Last Name (Student Who Referred the Program)*

Preferred Days*

Preferred Timings

Add Your Second Child

Details of the Second Child

First Name*

Last Name*

Date of Birth*

Gender*

Street*

Unit/Apt No*

City*

State*

Zip code*

Primary Mobile Number*(Country Code not required for Residents of Canada & US)

Studying in Grade*

Name of the School*

Add Your Third Child

Details of the Third Child

First Name*

Last Name*

Date of Birth*

Gender*

Street*

Unit/Apt No*

City*

State*

Zip code*

Primary Mobile Number*(Country Code not required for Residents of Canada & US)

Studying in Grade*

Name of the School*

Enrolment Agreement

A non-refundable Registration Fee is required at time of registration.
Student kit fees and course fees, activity fees and other material fees are non-refundable.
No placement is confirmed prior to any mode of payment.
One month notice or fee in lieu of, is required for any withdrawals.
There will be no discount or refund of course fees for any leave of absence during the term of the course.
The sibling discount of $10 per month is applicable on course fees only provided the 1st child is still enrolled in the OBotz program.
The course fees does not include any short term program. Eg. Summer Camp, Spring Workshop etc.
Payments are preferred through direct debit mode only unless otherwise specified
Any cheques returned NSF will incur a $25 service charge. Payments not received by the due date will incur late payment charges
There may be a minimum of $2 increase in monthly fee every year as per cost of living adjustment.

We realize that even under close supervision, children may have occasional accidents. Therefore, we hereby release for indemnity & hold OBotz USA, its franchisees, staff or volunteers harmless from any & all claims, damages or other liabilities for injuries to my child which are not a result of direct negligence of the staff.

We grant permission to the authorities at OBotz USA to use photographs and visual recordings of my child taken in the OBotz Centre or any other OBotz events, provided no identification (name or address) may be used for promotions unless explicitly authorized.

We, the undersigned, do hereby represent that all statements made by us on the Student Registration Form are correct, and we acknowledge that we have read, understood and agree to all terms and conditions of the registration, as set forth in the form.

I agree to the terms and conditions