Registration

First Name *

Surname *

Parent Name(If Under 18)

Date of Birth (dd-mm-yyyy) *

Gender at Birth

Male
Female

Email address

Contact Number *

City *

Country *

Services Interested In *

Group Classes-Mathematics
Group Classes-Additional Mathematics
Group Classes- online
Group Classes-in person (Saturdays)

Additional Comments

Privacy Statement : By submitting this form, you agree to the collection and use of your personal information by Mind Warriors Academy for the purposes of registration, communication, and service delivery. Your data will be handled securely and will not be shared with third parties without your consent, except as required by law.

Banking Details (please include the name of the student and subject in the details)

Beneficiary Name: Mind Warriors Academy

Beneficiary Account Number: 510 801 607 501

Account Type: Chequing

Bank Name:
Republic Bank Limited

Branch Address:
Cor. Murray St. & Ariapita Ave. Woodbrook