2023 The Resilient Child/Youth Form

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ORDER SUMMARY
Total costSGD
Level 1 (8 sessions) 9am -10.30pm Saturdays, 2024, 13 Jan - 9 Mar *Ages 6 to 12 years old, Location: City Sprout (Henderson Rd)
$680.00SGDEdit
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Level 1 (8 sessions) 10.45am -12.15pm Saturdays, 2024, 13 Jan - 9 Mar*Ages 6 to 12 years old, Location: City Sprout (Henderson Rd)
$680.00SGDEdit
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Total cost $0.00SGD
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Child Details * This field is required.
Name
Gender
Birth Date (dd/mm/yyyy)
Nationality
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Child Details* This field is required.
School
Level e.g Pri 3
Favourite Leisure Activities
Interests
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Parent/Guardian Details* This field is required.
Name
Relationship to Child
Contact No.
Email
Address
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Emergency Contact - other than above Parent/Guardian* This field is required.
Name
Relationship to Child
Contact No.
Email
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1. Please identify any concerns you may have about your child in the following areas (if appropriate or relevant):
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Attention control, easily distracted* This field is required.
None
Mild
Moderate
High
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Difficulty controlling emotions/emotional intensity* This field is required.
None
Mild
Moderate
High
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Issues with peer relationships* This field is required.
None
Mild
Moderate
High
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Anxiety (e.g. fear, prolonged worrying)* This field is required.
None
Mild
Moderate
High
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Social exclusion and/or bullying* This field is required.
None
Mild
Moderate
High
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2. Please clarify and elaborate on any concerns you have identified.
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3. What are your child's strengths?
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4. What do you wish your child to achieve from participating in this programme?* This field is required.
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Terms and Conditions

1. Registration and Payment

Places are allocated strictly on a first-come-first serve basis and will be confirmed on receipt of payment of the fee and registration form.

2. Refund and Cancellations

a) The full programme fee will be refunded if written withdrawal is received at least 14 days before the commencement of the term.

b) Cancellation within less than 14 days before the commencement of term is subjected to an administration fee equal to 50% of the programme fee. No refunds will be given for cancellations received after the commencement of the term.

c) Exceptions: If the child has incurred an injury (supported by doctor’s note) or is relocating from Singapore (supported by documentation), the programme fee will be fully refunded.

d) The Open Centre reserves the right to cancel a programme due to insufficient members. Parents will be notified at least 7 days prior to the commencement of the term and a full refund will be provided.

e) We make all effort to ensure that are no changes in terms of location, times or facilitators. In the case of unanticipated conflicts, a suitable replacement option will be offered. No refunds will be made in such cases. We will inform you by email or by phone of the change as soon as possible.

3. Liability

The Open Centre does not accept liability for personal injury or the death of any participants unless directly caused by the proven negligence of the company or its facilitators.

4. In case of any dispute, The Open Centre reserves the right to exercise final discretion.
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Check the following to proceed* This field is required.
I have read the terms and conditions of enrolment. Checking this option indicates my understanding and agreement.
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I have provided The Open Centre (S) Pte Ltd with all information necessary for the centre to plan safe and reasonable health care support for my child during the duration of the programme.* This field is required.
Yes
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Signature* This field is required.Click and hold your mouse/trackpad in the box to sign
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I would like to subscribe to The Open Centre's newsletters and marketing emails.* This field is required.
Yes please
No thanks
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