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Please Enter Details

Parent Forename

Parent Surname

Parent Email

Parent Phone

Parent Date of Birth

Relationship to Pupil

Pupil Forename

Pupil Surname

Pupil Date Of Birth

Pupil Gender

Does your child have any Special Education Needs or other diagnosed conditions? Please select from the list below:

Autism (including Asperger syndrome)

SPD (Sensory Processing Disorder)

PDA (Pathological Demand Avoidance)

Dyslexia

Anxiety

ADHD/ADD (Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder)

Other

Home Address

Please select the year of your child

Please select a pricing plan

Monthly-Plus Bundle Plan

Monthly-Base Bundle Plan

Monthly Custom Plan

For safeguarding purposes, we require a 4 digit security pin when speaking with parents on the phone. This will enable us to to verify that we are sharing your child's information with the appropriate people. Please state the 4 digit security pin you would like below

Confirmation

I confirm that I have completed sufficient research and am comfortable that the year group and subjects I have chosen are appropriate for my child's experience level

I agree to Bright Rising Stars' Terms and Conditions

I agree to atow Bright Rising Stars to store and process my personal data

Contact Us

Phone: +44 7554814898

Email: info@brightrisingstars.com

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