๐ˆ๐ง๐ฌ๐ญ๐ข๐ญ๐ฎ๐ญ๐ž ๐จ๐Ÿ ๐‰๐š๐ฆ๐š๐ข๐œ๐š ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ๐†๐ซ๐ž๐š๐ญ๐ž๐ซ ๐๐จ๐ซ๐ญ๐ฆ๐จ๐ซ๐ž ๐‰๐ฎ๐ง๐ข๐จ๐ซ ๐‚๐ž๐ง๐ญ๐ซ๐žย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย 
After school Programme For Children (Ages 6 - 17 Years Only)

๐—ก๐—•. For publicity of the Centres, performances done by students, photographs of students and their works may be published in the print, social and/or electronic media
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ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ๐‘๐„๐†๐ˆ๐’๐“๐‘๐€๐“๐ˆ๐Ž๐ ๐…๐Ž๐‘๐Œ ย 
PLEASE COMPLETE THE FOLLOWING FORM
SELECT ONE THAT IS APPLICABLE TO YOU *
REGISTRATION DATE *
MM
/
DD
/
YYYY
NAME (Surname/First Name/Middle Name) *
DATE OF BIRTH *
MM
/
DD
/
YYYY
AGE *
SEX *
HOME ADDRESS *
SCHOOL ATTENDING *
GRADE LEVEL *
PARENT/GUARDIAN INFORMATION
RELATIONSHIP TO CHILD *
NAME *
ADDRESS *
HOME PHONE NUMBER
MOBILE PHONE NUMBER *
WORK PHONE NUMBER
EMAIL ADDRESS
PLACE OF WORK AND ADDRESS
EMERGENCY CONTACT
NAME *
WORK PHONE NUMBER
MOBILE PHONE NUMBER *
HOME PHONE NUMBER
RELATIONSHIP TO CHILD *
DOCTOR'S CONTACT INFORMATION (Name/Address/Telephone Number)
PLEASE SELECT THE COURSES FOR WHICH YOU ARE REGISTERING YOUR CHILD.
Select only one course per day. (The time table is subject to change throughout the year).

Monday- Speech and Drama, Art and Craft & Sign Lanaguage.
Tuesday- Reading, Dancing andย Personal Development .
Wednesday- Drumming, Dance and Speech/Drama.ย ย 
Thursday- Drumming, Reading andย Speech/Drama.
ย Friday- Papermaking, Drumming and Music.ย 

COURSES AND DAYS. (CHOOSE 1 PER DAY).(Scroll across at the bottom of this table to see additional courses).
Speech/Drama
Art & Craft
Personal Development
Reading
Dancing
Drumming
Paper Making
Music
Monday
Tuesday
Wednesday
Thursday
Friday
Clear selection
COURSES AND DAY( CHOOSE 2)
Art & Craft
Reading
Speech & Drama
Dance
Personal Development
Music
Saturday
ADDITIONAL INFORMATION REQUIRED
NB.Your child will not be be discriminated against based on truthful information given.
Does your child have any illness/condition that would affect him/her participating in physical activities? ย If yes, please explain. *
Does your child have any allergies? ย If yes, please explain *
Has your child ever been referred to a Counselor/Psychologist? If yes, please explain *
Has your child done any form of assessment? If yes, please explain *
Does your child have any challenges that you would like the assistance of a Counselor? If yes, please explain *
If required would your child be available to participate in Junior Centre related activities/performing assignments on the weekends? If yes, select the day(s) on which he/she would be available. *
Required
Is your child allowed to be apart of research done at the Centres? (example completing short surveys/questionnaires). *
How did you find out about this programme? *
Required
PICK-UP ARRANGEMENTS
ย My child will:- *
Name and phone number of person who will be picking up your child (If child won't be picked up indicate not applicable) *
NB: Please email a photo of applicant(child) within a week after applying to ๐ ๐ฉ@๐ฃ๐ฎ๐ง๐ข๐จ๐ซ๐œ๐ž๐ง๐ญ๐ซ๐ž-๐ข๐จ๐ฃ.๐จ๐ซ๐ .๐ฃ๐ฆ. inlcude " PHOTO (Name of Applicant)-ASP" ย in the subject line.
AGREEMENT WITH TERMS OF THE PROGRAMME ย AND COVID-19 PROTECTIVE MEASURES ย  ย 
PLEASE CLICK ON LINK TO VIEW AGREEMENT WITH TERMS OF THE PROGRAMME AND COVID-19 PROTECTIVE MEASURES AND CODE OF CONDUCT.
Write your name if you have read the registration form and the Code of Conduct and will abide by the regulations of the programme contained therein. *
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