Curious Kind Application Form

Siblings Info

PERSON(S) AUTHORISED TO PICK UP THE CHILD
AUTHORISED PERSON 1
Relationship *
Name *
Phone Number *
Please enter a valid phone number.
AUTHORISED PERSON 2
Relationship
Name
Phone Number
Please enter a valid phone number.
AUTHORISED PERSON 3
Relationship
Name
Phone Number
Please enter a valid phone number.
EMERGENCY HEALTH INFORMATION
Emergency Contact Name *
Emergency Contact Phone Number *
Hospital Name *
Hospital Phone Number *
Doctor Name
Physical Health *

Good Other(please indicate) (any physical concern of which we should be aware)

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	5 Days	4 Days	3 Days (only applicable to N1)
Prepay Yearly
Prepay Term (Trimester)
Prepay Monthly (this option is only available for full 5-day program enrolment)

Curious Kind - Application Form