Enrolment Registration
--Acekidz @ Work

This form will take 10 - 15 minutes to complete.

You will need the following information:

  • Child's Birth Certificate / Passport No.
  • NRIC / Passport No. and employment details of Mother / Single Father / Guardian
  • All fields have to be filled up. Enter "NA" if not applicable.
Registration Number:
Programme:

Registration Date:
Please Enter Date.
A) CHILD'S PARTICULARS
Name:
Gender: Male   Female   Date of Birth: (dd/mm/yyyy)
Place of Birth:

Birth Cert / Passport / FIN / UNIN No.:
Birth Order: 1   2   3   4   No. of Siblings: 1   2   3   4  
Nationality:

Race:

Block No.:
Floor No.:
Unit No.:
Building Name:
Street Name:
Postal Code:
Choice of Mother Tongue:
Language spoken at home:
B) SIBLING INFORMATION
Has Current Sibling in Centre?
Sibling Birth Cert / Passport / FIN / UNIN No.   
Have you registered another of your children in this Registration?
Please provide the registration number of your other child : 2014-XX-XXXX   
C) TRANSPORT SERVICE
School Transport Required
Pick Up Address same as Residential?
If No, Please Fill In Pick Up Address
Block No.:
Floor No.:
Unit No.:
Building Name:
Street Name:
Postal Code:
B) PARENTS' / GUARDIAN'S PARTICULARS
Father / Guardian Mother / Guardian
Name (as in NRIC):

NRIC / Passport / FIN / UNIN No.:

Block No.:
Floor No.:
Unit No.:
Building Name:
Street Name:
Postal Code:
Home Contact:
Office Tel:

Mobile:

Working Status:


Occupation:


Religion:


Nationality:


*E-mail Address:


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C) EMERGENCY CONTACT (in the event that you and your spouse cannot be reached)
Name (as in NRIC):
Relationship:

Home Contact:
Office Tel:
Mobile:
 
Will you be using your Baby Bonus Scheme:
D) EMERGENCY CARE CONTACT (in the event of school closure due to unforeseen circumstances & epidemic situations)
Mother   Father  Care-Giver
Name (as in NRIC):
Relationships:

Block No.:
Floor No.:
Unit No.:
Building Name:
Street Name:
Postal Code:
E-mail Address:
E) MEDICAL HISTORY

Does your child have allergic reactions? E.g. foods, medicine, grass etc. Yes   No
If yes, please provide details:

If you child has any of the above medical condition, please provide details:
Does your child have any special needs/challenging behaviours? Yes   No
If yes, please provide details:

Does your child regularly visit a specialist? E.g. speech therapist, etc. Yes   No
If yes, please provide details:

I understand in case of accident or emergency, every effort will be made to contact me/my spouse immediately. In the event that my child requires medical attention, I authorise the school to obtain medical assistance, and agree to pay any medical/transport costs incurred.

Parent's Signature & Name:
Date:
Medical Practitioner: Medical Practitioner:
Doctor: Dentist:
Phone: Phone:
GENERAL INFORMATION
  • I give permission for my child to be observed, photographed and/or videoed by the school teachers and student teachers for training purposes.
  • I give permission for my child's photography and artworks to be displayed in our school's portfolio work, newsletter, in-house training materials and publicity materials. This includes materials placed on our website.
  • I authorize my child to be taken on routine excursions or outings and will not hold the school responsible for any unforeseen mishap/accident. (Ample notice of such excursions or outings will be given to parents.)
  • If I move house and no seat is available in the class (due to a change of session) or a seat on the bus (due to full capacity), the school will not be able to accommodate my child and I have to make alternative arrangements for schooling or transportation.
Parent's Signature:
Date:
*Submitted By:
*Relationship To Child:

*NRIC:
*Date:
I have read and agree to abide by the terms and conditions listed above.
(There will be a submission button below which will be disabled until the parent ticks the checkbox.)
*Verification Code: