Bethel Kinderlites

Bethel Kinderlites

  • CHILD'S PARTICULARS

  • MOTHER'S / GUARDIAN'S PARTICULARS

  • Emploment Details

  • FATHER'S / GUARDIAN'S PARTICULARS

  • Emplyment Detials

  • MEDICAL INFORMATION

  • Please enclose photocopies of your child vaccination / immunisation certificates indicating the dates i.e. poliomyelitis, trip antigen, measle and types of vaccinations.

  • Past History of infectious disease

  • Physical Disabilities

  • FAMILY DOCTOR

  • SOCIAL INFORMATION

  • EMERGENCY

    In case of emergency when both parents cannot be contacted, please call any persons named below

  • CONSENT

    Authorization

    In the event that I cannot be reached at the time of illness or accident, permission is hereby granted to Bethel Child Ddevelopment Centre and its staff to call a licensed physician of thir selection or if hospitalization is needed, my child will be sent to the nearest hospital and the medical fees and any other expenses such as transportation incurred on behalf of my child will be borned by me.

    General Permission

    In the vent of any supervised field trips, excursions, outing or while my child is at the centre, I will not hold the Centr or its staff responsible for any unfortunate accident, injuries, loss of personal items or live.The following individual is the only person authorised to pick up my child at the Centr. I will not hold the Centr for any damages, claims or liabilities which might result from the Centr and its staff releasing my child to any persons name below: