Summer School 2017 Montessori For Children (Broadrick Road) | Page 3

Tel: [phone] Email: [email protected] SUMMER SLAM 2017 APPLICATION FOR REGISTRATION FORM (Please detach and return to the office) Child’s Name: _________________________________________________ (Last, first, other) Date of Birth: Day ______ Month _______ Year _______ Address:_____________________________________________________ Tel: _________________________ E-mail: _____________________________________________________ Mother’s Name: ______________________________________________ (Last, First, other) Father’s Name:_____________________________________ (Last, First, Other) In an Emergency, contact: _________________ Tel: _________________ As the summer programme will involve handling various art materials, special snacks, water and outdoor play, please list in detail any specific instructions and health notes, i.e. allergies, you wish the teachers to note and follow with regard to your child participating in our planned activities. *For children not enrolled with us and are awaiting/pending September 2017 enrolments at Montessori For Children - Which Nursery/Kindergarten School is your child attending, if any? Parent's Name: _____________________________________________ Signature: __________________________Date: _________________ + Enclosed is my cheque No. ____________________ Bank _______ for $ _______.__ (Cheques should be made payable to ‘ MFC Kindergarten II (Broadrick Road)’