SPARK Programme - Registration - Products & Services -

SPARK Programme - Registration

TienerZone Inskrywingsform 2012.pdf

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Congratulations for qualifying for the Spark Programme. Kindly complete the registration form to become a SPARKIE.

Please note that all the fields must be completed.

*Before you start with the registration process, kindly download this document, sign it, and save it to your computer in order to upload it to your registration process.

*No registration will be accepted if this document is not uploaded.

You do have the option to fax/email it directly to us.

Fax 086 518 0840

email: domeniquef@minimax.org.za

Download Document

	Spark Registration document

	Child Name:
	Child Surname:
	Selected SPARK Campus:
	Child Date of birth (dd/mm/yyyy):
	Child current school:
	Parent/Guardian Name & Surname:
	ID number:
	Mobile Number:
	Email Address:
	Physical Address:
	Home telephone number (optional)
	Fax number (optional)
	Account holder Name:
	Email Address:
	Mobile Number:

	Kindly choose your payment option

		Option 1: Early Bird Offer (30 days after Spotlight)
		Option 2: SPARKIE Savings (30 days after Spotlight)
		Option 3: Great Value Offer (Until 30days before Spark)
		Option 4: Late Bookings (Within 30 days before Spark)
		Option 5: Family Savings (Siblings)
		Option 6: Europe Tour

	Kindly choose your payment method

		Full Down Payment via EFT - Option 1, 3 & 4
		Full Down Payment via Debit Order (Debit, Tjek or Credit Account) -Option 1,3 & 4
		Installments via Debit Order - Option 2
		Europe Tour - Special Arrangements to be confirmed

	Kindly complete the Medical information

	Contact person in case of emergency:
	Contact number 1:
	Contact number 2:
	Contact number of Local Physician:

	Kindly complete if your child has a medical condition

	Describe the condition:
	Describe symtoms:
	Describe Medication:
	Dosage for Medication:

	Please describe in detail if there is any medical condition that the Spark team needs to be aware of concerning your child.

	Kindly tick the box below if you have read and understood and accepted the terms and conditions and Spark programme rules.

		I hereby confirm that I have read, understood and accpet the terms and conditions and Spark programme rules.

	Kindly tick the box below to confirm that all the details you provided is 100% correct

		I hereby confirm that all the details provided is 100% correct and that I have the full authority to give this information and register the candidate for the spark programme.

	Kindly upload your signed copy of the contract that you were prompt to download in the beginning of the registration process.

	Please let us know if you submitted your forms using one of the following methods:

		I have Faxed the terms & conditions to 086 518 0840
		I have emailed the terms & conditions to domeniquef@minimax.org.za

	Please confirm your selected SPARK Campus:

		HS Die Anker - Ankertjie SPARK
		Europe Tour 2012
		Garsfontein SPARK Campus
		HS Hans Moore - Moories SPARK
		HS Jeugland - Jeugie SPARK
		HS Noord-Kaap - Northerns SPARK
		STAGE DOOR
		HS Uitsig - Chilli SPARK

	Other Campus:

Please calculate the following and enter the answer below: 1 x three + 2 + 4 = ?

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