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Child’s Information
Name
*
Date of birth
*
Gender
*
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Male
Female
Other
Prefer not to say
School name
*
Grade
*
Food-Related Allergy Details
e.g. peanuts, dairy (press enter after each)
Special needs
e.g. ADHD, speech therapy
Health conditions that might hinder light activities
e.g. asthma, anemia
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Guardian & Emergency Contact
Guardian Contact
(primary contact for the child)
Name
*
Relationship
*
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Mother
Father
Guardian
Other
Contact number
*
Address
*
Emergency Contact
(used if guardians cannot be reached)
Name
*
Phone
*
Relationship
*
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Name
*
Contact number
*
Relationship
*
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Mother
Father
Guardian
Other
Address
*
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Name
*
Phone
*
Relationship
*
Getting to Know Your Child
Hobbies
Has your child ever participated in a life skills course?
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Yes
No
Select areas for improvement
Table manners
Confidence
Social skills
Digital etiquette
Etiquette for special occasions
Personal grooming
How did you hear about us?
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Streaming Service Ad
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