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Child's First Name *
Child's Last Name *
Full Name *
Membership Number (if applicable)
Gender *	M F
Date of Birth *
HKID Number * / Passport number
Nationality *
Place of Birth *
School *
Child's contact email (if applicable)
Primary Parent/Guardian’s Name *
Primary Parent/Guardian’s Contact number *
Primary Parent/Guardian’s Contact Email *
Secondary Parent/Guardian’s Name *
Secondary Parent/Guardian’s Contact number *
Secondary Parent/Guardian’s Contact Email *
Notes (Medical History, Dietary Requirements etc.)
Referral
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