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					                                                                                                       AFFIX A
                                                                                                       PHOTOGRAPH
                      KINDERLAND (TYPHOON KIDS (M) SDN BHD)                                            HERE



KINDERLAND/CHILD CARE (                           )
REGISTRATION FORM
INSTRUCTION PLEASE COMPLETE THE FORM IN THE BLOCK LETTERS
                 *PLEASE DELETE WHERE INAPPLICABLE

 * CHILD CARE SERVICE                                   FOR OFFICE USE
   Fully Day Care/ Half Day Care                        STUDENT NUMBER
 * KINDERLAND/NURSERY CLASS                             COMMENCEMENT DATE
   1st Session / 2nd Session

                                                         (A) PARTICULARS OF CHILD
 NAME (Underline Surname)




 NAME IN CHINESE (if applicable)     PASSPORT/BIRTH CERT NO                              NATIONALITY


 ADDRESS



 POSTCODE              CITY/TOWN                                               STATE


 SEX                        RELIGION                  DATE OF BIRTH            RACE                    TELEPHONE (HOME)
   MALE         FEMALE

 CHILD’S MEDICAL HISTORY (e.g Asthma, Epileptic Fits, Allergy, etc)

   __________________________________________________________________________________________________________________________

   __________________________________________________________________________________________________________________________


                                               (B) PARTICULARS OF PARENTS/GUARDIAN
 FATHER’S/GUARDIAN’S NAME



 OCCUPATION                  TELEPHONE (OFFICE)               EXTENSION          IC/PASSPORT NO



 OFFICE ADDRESS



 MOTHER’S NAME


 MOBILE PHONE (1)                                                     MOBILE PHONE (2)



 OCCUPATION                        TELEPHONE (OFFICE)                 IC/PASSPORT NO



 OFFICE ADDRESS



 POSTCODE                   CITY/TOWN                                              STATE



                                                          (C) SOCIAL INFORMATION
1. Is your child allergic to any food? ______________________________________________________________________________________________

2. Has your child any particular illness or health problem? ___________________________________________________________________________

3. Briefly describe your child’s personality ________________________________________________________________________________________

4. Parents Living *Together/Separated/Divorced?”
   ___________________________________________________________________________________________________________________________


                                                                (D) RELEASE OF CHILD

The following named individuals are the only persons authorized to pick up my child from the Centre, and Kinderland is indemnified from any
damages, claims or other liabilities which might result from Kinderland (its employee) releasing my child to me or to any persons named below.


       (1)    Name ______________________________________________            (2)    Name ______________________________________________

              NRIC No ____________________________________________                  NRIC No ____________________________________________

              Relations to the child _________________________________              Relations to the child _________________________________

              Telephone No _______________________________________                  Telephone No _______________________________________

              Car Registration No __________________________________                Car Registration No __________________________________


                                                                FOR OFFICE USE ONLY

                             Registration Fees         School Fees          Supplementary Fees               Uniform               Others
Amount paid
O/R No
Date

                                                            MEDICAL AUTHORIZATION


       a) I understand that in the event of an illness or accident to my child, Kinderland Child Care Centre (“Kinderland”) will
          make reasonable attempts to contact me. When I am notified. I am required to pick my sick child immediately.

       b) I also understand that if my child shows any sign of being ill or unwell. My child shall be isolated from the other children
          and giver staff supervision until any arrangement can be made for his/her removal.

       c)     In the event that I cannot be reached, I hereby grant Kinderland full discretion to consult a licensed physician of
              Kinderland’s choice to attend to my child. All medical fees and other expenses shall be borne by me.

       d) I further understand that medication shall be administered by Kinderland’s staff according to the directions given by the
          licensed physician.

       e) I hereby agree not to hold Kinderland liable in any way whatsoever. For the medical treatment provided to my child at
          the centre.

       f)     The person(s) to be contacted in case of emergency are:


   (1)       Name _________________________________________                 (2)    Name ___________________________________________

             Tel No ________________(O) _________________ (H)                      Tel No ________________(O) _________________ (H)

             Relationship to child: ____________________________                   Relationship to child: ______________________________

             Address _______________________________________                       Address _________________________________________

                    ___________________________________                                    _____________________________________


                                                                         GENERAL
 a) I hereby undertake to be bound by the rules and regulations stated in the Parents’ Handbook, which I acknowledge
    receipt hereof.

 b) I hereby grant permiss ion for my child included in any photographs taken by Kinderland for the direct or in

 c) I hereby grant permission for my child to participate in any outings as Kinderland may conduct in connection with the
    activities of the child care centre.

 d) The cost of any such outings; stipulated by Kinderland from time to time, shall be borne by me.

 e) I understand that except in respect of death or personal injury caused by Kinderland’s negligence, Kinderland shall not
    be liable for any direct or conquential loss or damage. Any medical treatment provided by Kinderland at its expense
    shall be discretionary and on compassionate b basis only. Such medical treatment rendered shall NOT be taken as an
    admission of liability for any injury sustained.


                           RULES AND REGULATIONS FOR KINDERGARTEN/CHILD CARE

1. All lees paid are non-refundable or transferable.

2. All school and supplementary fees must be paid before or within the first week of each school term

3. Group Personal Accident Insurance Coverage Scheme is compulsory for all students at group rates

4. Termination in writing must be given to the school one month in advance. Or one month’s fee will be charged in lieu
   of notice.

5. The school reserves the right to transfer. Combine or dissolve a class.


6. The school must be notified immediately of any change in address or telephone numbers

7. Registration fee has to be paid if a student wishes to rejoin the school

8. All students are required to put on school uniforms and shoes

9. Permission is also granted for the use of the school photos of students for purposes of publicity and interpreting school
   programs

10. The school will not be responsible for any loss/damage of valuable belonging of students (jewellery. Watch etc)


                                            TADIKA & TASKA KINDERLAND
                                            TYPHOON KIDS (M) SDN. BHD.

                               Address: 4, Jalan Woodword, 30350 Ipoh, Perak, Malaysia.
                                     Telephone No.: 6 05 – 242 8661 / 254 0386
                                                Fax No.: 6 05 – 243 3661
                                             Email: info@kinderland.com.my
                                    Official Website: http://www.kinderland.com.my
                                             http://www.typhoonkids.com.my

				
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