Name Of Child (required)
Date of Birth (required)
Age(required)
Sex (required) --- Select Age---MaleFemale
Religion (required)
Home Address(required)
Closest Landmark
Type Of Program(required) --- Select Program---Infant Program( 4 to 14 Months)Toddler Program( 15 to 24 Months)Play Group Program(2 to 3 Years)Nursery(3 to 4 Years)Kindergarten- KG-I & KG-II( 4-5 & 5-6 Years)Standard I,II & III(6 to 8 Years)After School & Afternoon Boarding Program(3 to 12 Years)Activity Center(3 to 12 Years)Tuition Classes(4 to 12 Years)
Name Of School Attended
Year Of Admission
Type Of Programme
Reason For Change Of School
Mother's Name (required)
Mother's Mobile No(required)
Mother's E-mail(required)
Mother's Occupation (required)
Mother's Office Address (required)
Father's Name (required)
Father's Mobile No(required)
Father's E-mail(required)
Father's Occupation (required)
Father's Office Address (required)
Age Group ---Select----0-4 Years4-8 YearsAbove 8 Years Name Of School Attending
Weight (required)
Blood Group(required)
General Health
Allergies
Any Prevailing Medical Illness
Current Medications
Dietary Regalations
Name Of Family Doctor
Phone No. Of Doctor
Immunization Record Copy Attached
As Parent and/or guardian, I do herewith authorize the treatment by qualified and licensed medical doctor, of the following minor event of a medical emergency which,in the opinion of the attending physician, may endanger his/her life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me.
Relationship to Child
Address
Phone Number
E-Mail
I do hereby authorize Shree Ram International Pre School to release my child to the above listed people in the event I am unable to pick him/her up by myself. I release Shree Ram International Pre School from any and all responsibility for problems that may develop when such persons take my child from the premises.
Copy Of Birth Certificate (required)
Field Visit Form
Day Care Form
Photographs (required)
Parent Signature (required)
I hereby agree to the terms and conditions of Shree Ram International Pre SchoolI hereby agree to the terms and conditions of Shree Ram International Pre School
