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1 Step 1
School Holiday Workshops

30 May - 18 Jun 2018
Name of Parent
Mobile Number
Writing Boot Camp Price
Primary 5 Boot Camp
MindChamps Academy Workshop Price
Fully Booked
WorkshopQtyTotal
[field5]1[68*field7*(field11/100)]
[field6]1[field56*field8*(field11/100)]
[field51]1[field57*field46*(field11/100)]
[field64]1[60.99*field65*(field11/100)]
[field58]1[600*(field60+field61+field62+field63)*(field11/100)]
Promo Code(case-sensitive)
Discount
Name of Child
Date of Birth
Name of Child 2
Date of Birth
Name of Child 3
Date of Birth
Name of Child 4
Date of Birth
Dietary Requirements (if any)
Were you contacted by a MindChamps representative before?
Please indicate the MindChamps representative's name
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