Kidz R Os Registration Form

Child Registration Form
Please provide the details about the child and the parents required for the registration process.
Unless stated optional, all data are required to complete the registration process.

*Required
Child Details
Child's Name*

First NameMiddle NameLast Name
Date of Birth*

DayMonthYear
Child's CPR No.*

ddmmyy Last 4 digits
Gender*

MaleFemale
Nationality*

Languages spoken at home*

	Language 1	Language 2	Language 3

Any Allergies*

	Allergy 1	Allergy 2	Allergy 3	Allergy 4

Designated Parent Details

A designated parent will be responsible for pick up and will be the point of contact for the institution.
No. of designated parents:*
Relationship to child*

MotherFather
Please note a maximum of 2 designated parents are allowed per child. You cannot proceed further.

Mother's Details
Mother's Name

First NameMiddle NameLast Name
Mother's CPR No.

ddmmyy Last 4 digits
Mother's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mother's Mobile No.*
If Mother's mobile no. is not available, please mention primary contact no.
Mother's Alternate Contact No. Optional
Mother's Email ID

I/We confirm the following *:
*

The details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately.By submitting the form, I authorize the institution to reserve a place for the child whose details have been furnished above.I have read and understood and also accept the terms and conditions for admission to the institution.
I/We provide the following consents *:
The institute is allowed to photograph your child and publish images on Kidz R Os websiteKidz R Os is allowed to send email communications on your registered email ids.From time to time, Kidz R Os is allowed to send newsletters to your registered email ids.
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Child Registration Form