Annexure I


 Child's Name

 Date of Birth

 Program Start Date


 Program End Date


 School Name

 Home Address

 Parent's Name

 Medical Conditions

 Phone Number

 Emergency Contact Name

 Email ID

 Emergency Phone Number

In the case of an emergency, every effort will be made to contact the listed name. If unable to reach any of the contacts, I give permission to Novaleaf to secure proper emergency treatment while efforts to locate parent(s) continue:




 How did you find out about us?

 Can you provide your kid iPad for the Robotic Coding Programs?

By making this application to enroll my child in NOVALEAF INTERNATIONAL EDUCATION CONSULTING INC., I agree and consent to the NOVALEAF Program Policy Agreement.


 Print Name


Registration cannot be confirmed unless the form is accompanied by an e-transfer to OR a cash payable at our front desk.