Registration Form

Student's Surname/Family Name

Student's First Name

Student's Preferred Name

Nationality

Upload a recent photo of student

X

Student's Date of Birth

Gender

.

Male

.

Female

Name of School (if known)

Name of Boarding House (if known)

Father's Name

Mother's Name

Home Address

Home Telephone No.

Work Telephone No.

Emergency Telephone No.

Father's Telephone No.

Mother's Telephone No.

Student's Telephone No.

Father's Email

Mothers Email

Student's Email

Emergency Email

Are there any medical conditions or allergies that we should be aware of?

.

Yes

.

No

If yes, please give details

Is the student comfortable around family pets?

.

Yes

.

No

Comments

Please state who is responsible for paying the fees

How did you hear about Crown Guardians?

*Parent's Signature

*Submission Date

I/We agree to Crown Guardians (Bath) Ltd. storing this information, and sharing it with those persons who are directly involved with my child/children and need to know this information.

.

Agree

If you require any information about how we can help you, please contact us.

contact us