Enrolment form

Select State*

City*

UCMAS Centre*

Details of the Child

First Name*

Last Name*

Date of Birth*

Gender*

Street*

Unit/Apt No

State*

City*

Zip Code*

Primary Mobile Number*(Country Code not required for Residents of Canada & US)

Studying in Grade*

Name of the School*

Details of the Parents

Mother’s Name*

Father’s Name*

Mother’s Cell*(Country Code not required for Residents of Canada & US)

Father’s Cell(Country Code not required for Residents of Canada & US)

Email address 1*

Email address 2

General Details

How did you hear about UCMAS?*

First Name (Student Who Referred the Program)*

Last Name (Student Who Referred the Program)*

Preferred days*

Preferred timings

Emergency Contacts

Name*

Tel*(Country Code not required for Residents of Canada & US)

Authorized Individuals to Pick Up Student

Name*

Relation*

Enrolment Agreement

A non-refundable Registration fee is required at time of registration.
Student kit fees and course fees, activity fees and other material fees are non-refundable.
No placement is confirmed prior to any mode of payment.
One month notice or fee in lieu of, is required for any withdrawals.
There will be no discount or refund of course fees for any leave of absence during the term of the course.
The sibling discount of $10 per month is applicable on course fees only provided the 1st child is still enrolled in the UCMAS program.
The course fees does not include any short term program. Eg. Summer Camp, Spring Workshop etc.
The preferred form of payment is via pre-authorized debit, unless otherwise specified.
Any cheques returned NSF will incur a $25 service charge. Payments not received by the due date will incur late payment charges
There may be a minimum of $2 increase in monthly fee every year as per cost of living adjustment.

We realize that even under close supervision, children may have occasional accidents. Therefore, we hereby release for indemnity & hold UCMAS USA, its franchisees, staff or volunteers harmless from any & all claims, damages or other liabilities for injuries to my child which are not a result of direct negligence of the staff.

We grant permission to the authorities at UCMAS USA to use photographs and visual recordings of my child taken in the UCMAS Centre or any other UCMAS events, provided no identification (name or address) may be used for promotions unless explicitly authorized.

We, hereby, represent that all statements made by us on the Student Registration Form are correct, and we acknowledge that we have read, understood and agree to all terms and conditions of the registration, as set forth in the form.

I agree