Otuzemba Adventist Private School

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Doctor's Name

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Immunizations Up to Date

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I consent to first aid being administered to my child in an emergency

Father Details

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Father's Employer

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Mother Details

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Guardian Details (if applicable)

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Bank Name

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Emergency Contact Name

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Emergency Contact Phone

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Transport Needed

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Special Dietary Requirements

How Did You Hear About Us

Co-curricular Interests

Birth Certificate Copy

Parent's ID Copies

Proof of Residence Document

Registration Fee Paid

Application Fee Paid

I Accept the Contract

Contract Start Date

Place

Signature

Date Signed

Outing Consent

I Accept the Indemnity

Parent/Guardian Signature

Witness Name

Witness Signature

Date Signed

Place Signed

I Accept the Financial Obligation

Parent Full Name

Parent ID Number

Learner Name

Learner Grade

Signature

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Father Details

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Guardian Details (if applicable)

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Learner (Pupil) Details

Student Identity

Academic History

Medical Information

Parent / Guardian Details

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Mother Details

Guardian Details (if applicable)

Contact & Address Information

Account & Communication

Emergency Contact

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Required Documents

Contractual Agreement

Indemnity & Consent

Financial Obligation

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