Leadership Workshop

* Complimentary to fill up

GUARDIAN'S DETAIL

*Name:

*Phone Number:

*Email:

CHILDREN'S DETAIL

First Child:

*Child's Name:

*Child's Age:

*Date of Birth:

Second Child (if any):

Child's Name:

Child's Age:

Date of Birth:

Tick here if you have more children

WORKSHOP'S DETAIL

*Choose your session:

**Food allergic/ vegetarian:

*Pax of Parents Joining (MUST):

**Please indicate if there is any

*Which State/Country(Non-Malaysian) are you from?

*How do you know about us?

Friends / Coach who refers you:

*If you have a magic wand, what are the improvements that you would like to see in your child? (answer for each child)

*What do you want to achieve (for yourself & your child) from this workshop?

*What benefits will this improvement have for you and your child?

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