ICN Academy Registration
Please fill the details to add your child(ren) to our waiting list. For more information, please contact us about this form.
* denotes required field
*Your name: (Parent/Guardian)
*Surname:
*Relation to child:
Autofill:
Father
Mother
Brother
Sister
Type:
SELECT ↵
Parent
Sibling
Emergency
Other
*Your email:
*Confirm email:
Telephone:
Mobile:
Address:
Postcode:
Students
Child #
1
:
Surname:
D.O.B:
Gender:
SELECT ↵
Male
Female
Email:
Add medical info/notes
Medical Conditions
General Notes
500
remaining
Add Another Child
Contacts
You are the primary contact. You can add more contacts below.
Additional Contact #
1
Contact Name:
Email:
Tel.:
Mobile:
Alt. Mob.:
Relation:
Type:
SELECT ↵
Parent
Sibling
Emergency
Other
Primary Contact?
This means the contact will receive emails related to the child. The contact will also see the child on the parent portal to view progress and other information. If you select no here, this contact will not see the children on the parent portal.
Add Another Contact
I consent that IBEUK can process this form and submit directly to ICN Academy. Your data will not be stored nor used by us.
Submit Application