GOD Brisbane- Register for Gopa Kuteeram Program
Register for Gopa Kuteeram Program Brisbane
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Email *
Child 1 Full Name *
Child 1 Gender *
Child 1 Date of Birth *
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Child 1 School Year
Child 1 Any Allergies & Medical Information *
Child 2 Full Name
Child 2 Gender
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Child 2 Date of Birth
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Child 2 School Year
Child 2 Any Allergies & Medical Information
Child 3 Full Name
Child 3 Gender
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Child 3 Date of Birth
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DD
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Child 3 School Year
Child 3 Any Allergies & Medical Information
Father Name
Mother Name
Mobile Number *
Alternate Number
Emergency Contact Name *
Emergency Contact Number *
Center of Choice *
Opt-in Updates for
I give permission for my Child / Children to attend the Gopa Kuteeram classes organised by G.O.D Australia. I agree that my child will abide by the rules and regulations of the class. I give permission for photos and videos to be taken of my child during the classes that may be published in G.O.D website, Facebook, Newsletters and any promotional brochures or materials.  I understand that every precaution is taken to secure the safety of each student, however in case of an accident, I agree to release G.O.D. from any liabilities. *
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