Quick Signup To Victory Park Play School

Quick Signup To Victory Park Play School

Fill out this form to sign up quickly and easily.
Full Name Of Applicant

First NameLast Name
Date Of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Age

1. Learners Personal Details
Full Name Of Learner

First NameLast Name
Date Of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Age
Race
Gender
The Learner Is
Allergies
Medical Conditions (Specify)
Name Of Family Doctor

First NameLast Name
Phone Number Of Family Doctor
Please enter a valid phone number.Format: (000) 000-0000.
Name Of Person To Contact In An Emergency

First NameLast Name
Phone Number Of Person To Contact In An Emergency
Please enter a valid phone number.Format: (000) 000-0000.

5. Consent And Permission
5.1 I {q2_fullname0} (parent/legal guardian) of {fullName} hereby give permission for him/her to participate in the various activities (including but not limited to class activities, sports activities, and educational and recreational activities and outings) arranged, organized, and oﬀered by the school, and where relevant to him/her being transported to and from the said activities by means of transport made available by the school for that purpose.

5.2 I further agree to the condition that while every precaution will be taken for the safety and welfare of my child and for the care if his/her possessions, I will absolve and indemnify all persons, Victory Park Playschool and all other organizations associated with the activity, should any prejudice, loss, damage, illness or injury occur to my child. This includes an indemnity against recovery of costs resulting from damage, loss and/or medical conditions, or hospitalizations.

5.3 As parent/guardian of {fullName} I hereby allow the school to obtain urgent medical treatment for my child should this be deemed necessary. The centre shall however contact us to advise us on the nature of the treatment required. As far as I know he/she is physically capable of participating in the above activities and he/she is in good health.
Signature Father/ Guardian
Signature Mother/ Guardian
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
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