PROG RAM M E REGISTRATIO N FO RM STUDENT'S PARTICULAR Full Name (according to MyKid or MyKad): NRIC No (according to MyKid or MyKad)/Passport No: Gender: Date of Birth (dd/mm/yyyy): Age (on year of enrollment): Allergies (if any): ADMISSION TO HOLIDAY PROGRAMME Month/Year of Admission: Programme Type and Name: PARENT OR GUARDIAN'S PARTICULAR MyKad)/Passport No: Contact Mobile No: Contact Home No: Email Address: Workplace Address: EMERGENCY CONTACT INFO (other than parent/guardian) Full Name: Contact No: Relation to the student (e.g. grandparents, aunty, uncle), please specify: Unit 53-7, Level7, The Boulevard, Mid Valley City, Lingkaran Syed Putra, 59200 Kuala Lumpur. Tel: 603-22800131 Relation to the student (e.g. grandparents, aunty, uncle), TERMS & CONDITIONS 1. 2. 3. 4. 5. 6. 7. Preliminary registration is subject to receipt of payment in full before the date of programme commencement, for full confirmation. Cancellation of confirmation shall be in writing, or emailed and a 75% refund is allowed if cancellation is at least five (5) working days before the . Substitutes (of equivalent value) are allowed if changes are acknowledged by CRAFTY MINDS at least fi . There will be no replacement classes/sessions for non-attendance (except for courses that have flexible time). Workshops that have flexible times to complete must be completed within the 12 months from the date of commencement. The participants and guests shall indemnify CRAFTY MINDS SDN. BHD. from any claims whatsoe . CRAFTY MINDS reserves the right to make changes to the programme schedule if warranted by circumstances. I hereby have read, understood and agree to abide by the Terms & Conditions above. I also agree to hereby release all of CRAFTY MINDS staff and employees of any liability for damages arising from any personal property loss or any injury sustained while participating in any activities at/by CRAFTY MINDS SDN. BHD. I hereby declare the abovementioned information completed by me as true and correct in all respects. Signature: Name: Date: OFFICIAL USE Holiday Programme: Day / Date: Facilitator: Fee: Remarks: Payment Date: Debit ATM, Online Banking Debit & Credit Card payments are accepted at CRAFTY MINDS SDN. BHD. For cheques or bank in: CRAFTY MINDS SDN. BHD. - RHB bank a/c 2140 9900 0749 50. Unit 53-7, Level7, The Boulevard, Mid Valley City, Lingkaran Syed Putra, 59200 Kuala Lumpur. Tel: 603-22800131
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