Please complete the following form to register for the Jump Into Coding school holiday program. Attendee details: First name:* Last name:* Age:* Guardian details: First name:* Last name:* Address 1:* Address 2: Email:* Phone:* Postcode:* Session times: We will have the same program operating over two weeks, at two different session times. Please select one preference. Group One will be: 18th, 19th, 20th January 2021 Group Two will be: 25th, 26th, 27th January 2021 Please select which holiday group program you would like to join: Group One: AM Session: 9 – 11:30am Group One: PM Session: 1 – 3.30pm Group Two: AM Session: 9 – 11:30am Group Two: PM Session: 1 – 3.30pm Please note any special requirements: Our team will contact you within two business days to confirm your registration. Leave this field blank Children