Kindercare

Child's Information *

Child’s Name

Family Name

Place of Birth

Date of Birth

Nationality

Gender

Male

Female

First Language

Other Language

Father’s Information *

Father’s Name

Occupation/ Place of work

Work Phone Number

Mobile Number

Email Address

Mother’s Information *

Mother’s Name

Occupation/ Place of work

Work Phone Number

Mobile Number

Email Address

Residence Information *

Tel. Res.

Residence Address

• Contact numbers In case of emergency ( if parents are not immediately available mention the relation with the parents )

1. Other Information

Telephone Number

Name/Relation to the child

2. Other Information

Telephone Number

Name/Relation to the child

1. Siblings

Name

Age

Current school

2. Siblings

Name

Age

Current school

Other Information

In case of parents are divorced, specify the name of the guardian

Previous nursery attended(please give details)

Does your child have any medical or psychological condition? if yes please give details

Age Information *

Child’s Age Level

1 - 2 yrs

2 - 3 yrs

3 - 4 yrs

1. Pick Up Person Information *

Persons authorized to pick-up my child other than parents (2 additional)

Name

Phone

Emirates ID

Relationship to child

2. Pick Up Person Information

Name

Phone

Emirates ID

Relationship to child

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Registration Form