KSPACE SUMMER SCHOOL 2024

BOOKING FORM FOR OVERSEAS RESIDENTS

General Information
1) Are you an enrolled Kspace member?	No   Yes
2) Please choose your preferred membership option: *Guest Visitor Only Membs covers this winter school only and cannot be deducted from any other type of membership in the future.	Guest Visitor Only (*¥10,000 per child) Kspace Midweek Memb (¥20,000 per child) Saturday Memb (¥40,000 per child & ¥10,000 annual fee)
3) Has your child ever attended a Kspace Spring/Winter/Summer School?	No   Yes
a)If 'Yes' to the above, please give details of programme
b)If you answered 'No' to the above, have you ever visited Kspace before?	No   Yes

Student's Information
Surname (family name) *
Forename (first name) *
Gender	Girl Boy
Date of birth (DD/MM/YY) for example born 25/Oct/2019 *	dd 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 M Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec yyyy 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Please select date of birth
Nationality/Nationalities (on passport)
Child's Passport Number (Note: we will also need a supplied photocopy of relevant pages by 1st day)
1st Language
Other Languages
English Language Level	Complete Beginner   Beginner   Intermediate   Advanced / Fluent
If your child has studied English before please tell us where/how:

Student's Medical Information	No	Yes (Please provide information)
Does your child have any physical challenges or limitations at all?	No	Yes
Does your child have any cognitive, behavioural or social challenges or limitations at all?	No	Yes
Does your child suffer from hayfever and do they ever take drugs for hayfever?	No	Yes
Does your child have asthma, and if so do they need an inhaler?	No	Yes
Does your child have any allergies at all? (state the allergy, its intensity and if they also require an Epi-Pen)	No	Yes
Has your child received all vaccinations recommended in Japan?	No	Yes
Does your child have any special diet (please list)?	No	Yes

Parent/Guardian Contact Information	Address in Japan
Please list the name of the primary English speaker in 'Parent A', if you have an English speaker in your family.
Parent A's Name (first name/family name) *
Relationship to Student
Nationality
Contactable/Main Parent's Passport Number (Note: we will also need a supplied photocopy of relevant pages on 1st day)
Parent B's Name (first name/family name)
Relationship to Student
Nationality
Permanent Address
Postcode
Fixed address in Japan once you have arrived Note: Parents who cannot provide this at time of the booking must send it to us before the attendance days, as a mandatory requirement.
Regular/international Telephone Number
Mobile *
Telephone number in Japan Note: We prefer that this is a Japanese domestic/mobile phone number for the purpose of emergency/evacuation etc.
Please state parents reasons for entry into Japan (business/travel/adult study)
Incoming flight date into Japan and country of departure
Company address and contact in Japan (if parents are entering for business purposes)
Email Address * Note: Please do not provide mobile phone provider email address

Summer School Uniform
Dress (number of items)	0   1   2   3   4   5
Shorts (number of items)	0   1   2   3   4   5
T.Shirt (number of items)	0   1   2   3   4   5

 

Please add a tick mark ( ✔ ) in the boxes on the dates/courses/times that you would like your child to attend.

To give you an accurate invoice please complete fields for every date that you want to book.

Booking Dates (Summer School - July 22nd to August 17th, 2024)
MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY
July 22 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	July 23 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	July 24 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	July 25 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	July 26 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	July 27 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm
MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY
July 29 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	July 30 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	July 31 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	August 01 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	August 02 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	August 03 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm
MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY
Aug 05 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 06 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 07 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 08 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 09 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 10 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm
MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY
Aug 12 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 13 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 14 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 15 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 16 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 17 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm
Booking Dates (SUMMER SCHOOL EXTENSION - August 21st to August 30th, 2024)
MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY
AUG 19 School Closed	AUG 20 School Closed	Aug 21 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 22 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 23 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 24 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm
MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
Aug 26 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 27 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 28 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 29 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm	Aug 30 Regular Programme 9.00am to 3.00pm After School 3.00pm to 4.00pm 4.00pm to 5.00pm Breakfast Club 8.00am to 9.00am Extension Hrs 5.00pm to 6.00pm 6.00pm to 7.00pm

 

IMPORTANT NOTES & AUTHORISATIONS

All new students to Kspace must take a paid trial before Summer School.

If you are overseas you must arrange a screening and meeting via Zoom (as mentioned above) @ ¥15,000 pretax per student. If your overseas family will arrive in Tokyo before Summer School begins, we might also request that you arrange a paid trial on-site class prior to July 19th.

Bookings are only secured with full payment. There are no paid trials after July 19th 2024, and any attendance in Summer School incurs membership/materials and uniform fees.

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