Online Application

Student's Full Name

Student's Date of Birth

Student's CPR

Parent's Mobile

Parent's Email

Block Number (Home Address)

I would like my child to attend:

My preferred timing is:

I am registering for the month(s) of:

January

February

March

Please tick what best decribes your child:

My Child is Verbal

My Child is Non-Verbal

My Child Communicates withs Signs/Gestures

My Child is on the Autism Spectrum

My Child has Behavioral Challenges

My Child has Physical Restrictions (Cerebal Palsy, Uses Aids, Poor Coordination)

Thank you for completing the form. Our LVC admin team will contact you to confirm the registration.