Instructions
I. Form to be filled neatly and legibly.
II. Form to be filled by the parent / guardian.
III. Ensure you attach all the necessary documents given in the checklist.
Child Details:
1. Name of the Child (Full name in capital letters) :
2. Date of Birth :
3.Years:
Months:
4.
5.
6.
7. Place of Birth :
8. Nationality :
9. Mother Tongue:
10. Medical Details :
11. Father's Details:
a. Name:
b. Occupation :
c. Place of work :
d. Office address :
e. Email :
f. Contact no. :
12. Mother's Details:
a. Name:
b. Occupation :
c. Place of work :
d. Office address :
e. Email :
f. Contact no. :
13. Sibling Details
KID'S NAME | GENDER | AGE | CLASS | SCHOOL |
|---|---|---|---|---|
Katie | Kale | 3 | 4:30pm | |
Nicki | - | 2 | 4:00pm | |
Dwayne | Eggs & Gluten | 2 | 3:30pm | |
Bob | - | 3 | 4:30pm |
14. Residential Address:
Contact no. :
a. Name:
b. Relationship with the child :
c. Contact no. :
15. Emergency Contact Details (This detail will be used during emergency when both parents are not available)
a. Name:
b. Relationship with the child :
c. Contact no. :
d. Address :
a. Name of the school / daycare ::
b. Duration :
c. Class attended :
DECLARATION BY PARENT / GUARDIAN
I, Parent / Guardian of
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do hear by understand and accept the following fully :-
(a) I certify that the above information is correct and affirm that I will abide by the rules and regulation set by the school.
(b) In case of any accidents or illness, the school authorities may take the child to the hospital / nursing home as per the condition of the child.
(c) I will not hold the school authorities responsible for any kind of mishap of my ward by events that are accidental in nature.
(d) I shall permit the school management to take pictures of my child at school and can be used for school prospectus, school magazines only by keeping me informed before the use.
(e) The documents submitted with this form as mentioned in the checklist of my child are authentic originals or true copies of the documents.
(f) I hereby state and declare that should I or my child not fulfill any one of the above conditions fully or partially or have furnished false documents or incorrect information , then school authorities have the right to strike off the name of my child from the school rolls and my child will be considered withdrawn from the school by me.