2026 Registration Form
Child Particulars:
Full Name
*
First Name
Surname
Nickname (if any)
Date of birth
*
-
Month
-
Day
Year
Date
Identity Number
*
Gender
*
Please Select
Male
Female
Race
*
Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Medical condition
upload photo of child
*
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Copy Birth certificate
*
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Copy of clinic card/immunization card
*
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Back
Next
Parent/guardian particulars
Full Name
*
First Name
Surname
Title
*
Please Select
Mr
Ms
Mrs
Identity Number
*
Phone Number
*
Alternative Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
upload proof of income or affidavit if not working/ receiving grants or hand deliver
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Submit
Should be Empty: