Student Information


* First Name:

  

*Last Name:

  

Birthday:

  

day/month/year

Gender:

  

Phone number:

  


Street Address & City:

  

*Contact e-mail address:

  

Contact person in case of  an emergency:

  
Relationship to student
  

:

 


Tel (H):
(W):




Medical Details

Please inform us of any medical conditions we should know about

List any known allergies or medical conditions

  

Does your child take any special medication for these or any other problem?

 

Special dietary needs

  

Do you give permission for us to administer paracetamol should the child need it?

  

Contact name and tel number of physician

  

Program Details

Select the program you would like to enrol your child in:

 

Transportation Options

Please check the box(es) below if you would be interested in:
Car pooling with other parents   the school van service from Buhangin to Cabantian
If you checked both of the above boxes, please indicate which option you would prefer:

Payment Options

*Cash payments can be made at the centre in Cabantian. Remember an early bird discount applies.
*Checks to be sent to: Kids Worldwide, c/o Lot 10, Block 20 Elenita Heights Subd,Catalunan Grande, Davao
* Internet payment options are currently being researched.

Please indicate how you intend to pay:
How did you find out about this program?