SOCIAL THINKING CAMP 2018
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I am interested in joining the camp on *
Participants name *
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Gender *
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Grade
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Diagnosis, if any
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Date of birth *
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Fees (Inc. GST)
Payment method
Payee: Oasis Place Sdn. Bhd.
Bank: CIMB
Account no: 800 711 3565
Kindly forward remittance copy to events@oasisplace.com.my
Name of Sibling (If register as additional sibling)
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Age of Sibling (If register as additional sibling)
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Current Address
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Home phone number
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Mother's name
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Mother's mobile number
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Mother's email address
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Mother's occupation
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Father's name
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Father's mobile number
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Father's email address
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Father's occupation
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Primary contact person *
EMERGENCY Contact #1 Name
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EMERGENCY Contact number
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Relationship
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Current medications *
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Medical conditions *
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Allergies *
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Food restrictions *
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Seizures (yes/no) *
Other information
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In case of emergency, i understand that every effort will be made to contact me or the contact people listed above. If I cannot be reached, I understand that staff will use a standard 999 protocol and have my child taken to the nearest hospital.
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What kind of school does your child attend?
Name of the school
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What do you hope your child will gain from his/her experience here?
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Is your child able to participate in a group activity for half and hour without breaks?
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Provide any information that will assist the group facilitator in structuring the sessions for the child's greatest success (e.g. visual schedules, short breaks every 15 minutes, behaviour management sessions)
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Please suggest some ways to help your child to calm down if he or she is upset. *
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Is your child toilet trained? *
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