Kids Palace

Kids' Palace School

Please fill out this form neatly with blue or black ink with all required information

Surname *

First Name *

Other Name(s)

Date of Birth *

Gender *

Nationality *

Religion

Mother Tongue *

Previous/Present Class *

Name of Previous School (if any)

Physical Problems/Disabilities (if any)

Name of Father/Guardian *

Phone Number *

Residential Address *

Level of Education

Occupation

Relation to Pupil

Name of Mother/Guardian

Phone Number

Residential Address

Email *

Level of Education

Occupation

Relation to Pupil

Any third relative who could pick the child in absence of parents (must be 17 years or above)

First Name *

Last Name *

Phone Number

A. Blood Group *

B. Genotype

C. Underlying Sickness

D. Allergies