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Bala Kendra Registration Form

Dear Parents

Thank you for your interest in our Bala Kendra Programme. 

Please complete all the required fields below:

Membership
Member of Amriteswari Society

1.  If you are a current Member of Amriteswari Society, please proceed to complete this Form. 

2. If you have answered "No" above, you may wish to become a Member and enjoy the Members benefits in signing your child up for our Bala Kendra Programme. 

If so, please go to the MEMBERSHIP APPLICATION FORM and return to this Registration Form after you have submitted your Membership Application.

3. If you do not wish to become a Member, you may proceed to complete your child's registration. 

4. If you have just submitted your Membership Application kindly provided the date of submission below, for verification purposes:

Society Membership Application Submission Date:only for parents who have just submitted the application
CHILD 1
Name of Child
Date of Birth
Age
Medication or Medical Conditionsif any
0 /
Food Allergiesif any
0 /
Child 2*
Name of Child
Date of Birth
Age
Medication or Medical Conditionsif any
0 /
Food Allergiesif any
0 /

*If you would like to register more than 2 children please use an additional form. 

Parents' Particulars
Names of Parentsor Guardian
Mobile Number
Emergency Contact Number
Message
0 /
Payment for Term (Jan - Mar 2020)

Please select the appropriate category. If you have just submitted your Membership Application, you may select the Members rate at this point. Should your Membership Application be rejected, you will then be required to pay the balance amount.

MEMBER'S CHILD 1
MEMBER'S CHILD 2
NON-MEMBER'S CHILD 1
NON-MEMBER'S CHILD 2

Please note that we will receive payment via the following mode: 

PayNow [kindly use our UEN: S96SS0126E, and mention 'BK Jan 2020 [Your Name]'. Registration is confirmed only upon payment


PRIVACY CLAUSE

By providing your personal data (or those of your children or ward) to Amriteswari Society (the “Society”), whether in writing, by email or other electronic means, you consent to the Society’s collection, use and disclosure of your personal data for the purpose of your membership in the Society; your participation in the Society’s activities and programmes; and for the Society’s administrative purposes (collectively the “Purposes”). You further consent to the Society transferring your personal data to any third party engaged by the Society to assist the Society in carrying out the Purposes. The Society will at all times be primarily responsible for your personal data. The Society respects your personal data and will not use your personal data for any other purpose except the Purposes.You hereby grant consent to the Amriteswari Society to take and use yours (parents) and your child’s image in any format for purposes of display, publicity and advertisement by the Society and in its promotional materials and website.


DISCLOSURES & COMMENTS

I have disclosed all relevant medical, psychological and special needs information about my child. I understand that my child will be taught by volunteers who are not trained professionals.I also understand that at no time will Amriteswari Society volunteers administer medicine or other treatment.. I am aware that registration cannot be adjusted to take into account any special needs and the child will not be accepted into the programme.I also understand that at no time will Amriteswari Society volunteers administer medicine or other treatment. In the event of an emergency or my child being unwell, I must urgently collect or make arrangements for the collection of my child as directed by the officials of the Bala Kendra Programme.I understand and acknowledge that I am fully aware of the content and nature of a Bala Kendra programme and assume all the possible risks of the child’s participation in the Bala Kendra Programme.I hold harmless and agree to indemnify Amriteswari Society, its officials and agents, from and against any present or future claim, cause of action, loss or liability for injury to person or property, which the child may suffer in relation to or arising from the child’s participation in the Bala Kendra Programme.I have fully read, understood and agree to all of the above.


By clicking SUBMIT, I confirm the above and that I have read, understood and agree to the policies and procedures for the registration of my child in Amriteswari Society's Bala Kendra Programme.


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