Child's Information

Child’s recent unfiltered photo (file size limit: 2 MB)

School Information

—Please choose an option—Krugersdorp High SchoolHoërskool Jan De KlerkCurro Krugersdorp High SchoolTownview High SchoolKrugersdorp Town SchoolMonument Primary SchoolLaerskool MillenniumSilverfields Primary SchoolLaerskool Krugersdorp NoordCurro Krugersdorp Primary SchoolSt Ursula's SchoolAlma Mater International SchoolAlma Mater Primary SchoolOther

Route Details

Primary Parent / Guardian Information

Secondary Parent / Guardian Information

Account Holder Details

Who will be responsible for payment of this account?

—Please choose an option—Primary ParentSecondary ParentOther (Specify Below)

Which payment method do you prefer?

Monthly InvoiceDebit OrderEFT (Manual Payment)

I hereby authorise MTM93 (PTY) LTD to deduct the agreed monthly transport fees via debit order from my nominated bank account. I confirm that I have selected "Debit Order" as my payment method and understand that this authorisation remains valid until cancelled in writing.

Emergency Contact (other than parent)

Medical Information

Additional Notes

I confirm that the above information is accurate and can be used in case of emergency.