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Summer School Application Form
Child Information
Full Name
(Surname First)
*
Date of Birth
*
Gender
*
Gender
A
Male
Gender
B
Female
Home Address
*
Class by new session in September
*
Class by new session in September
A
Creche: 3 months
Class by new session in September
B
Playgroup 1 : 15 months
Class by new session in September
C
Playgroup 2 : 2 years
Parent/Guardian Information
Title
*
Full Name
*
Phone Number
*
Email Address
*
Relationship to Child
*
Emergency Contact
Full Name
*
Relationship to Child
*
Phone Number
*
Authorized Pick-Up Contacts
Authorized
Contact Name
*
Authorized
Contact Phone Number
*
Note:
Valid ID will be required at pick-up.
Allergies
*
Medical Information
Medical Conditions
*
Immunization Status
*
Upload Proof of Payment
Proof of Payment (Receipt)
*
Click to choose a file or drag here
Size limit: 10 MB
Consent & Agreement
*
Consent & Agreement
I have read and agree to abide by the school's policies and procedures as outlined in the parent handbook.
I confirm that the information provided in this application is accurate and complete to the best of my knowledge.
I consent to photographs being taken of my child during school activities for documentation purposes.
I understand that photographs may be used in a promotional context and consent to such use.
In the event of an accident, I grant permission for school staff to administer first aid or call an ambulance if necessary.
Signature & Date
Signature
*
Today's Date
*
Reminder: Your application will only be processed once proof of payment has been received.
Submit