Name*
Age*
Sex*
Address* Flat & Floor
Building / Block no.
Estate / Street
District
Tel no.* (Please provide at least one contact no.) mobile phone / pager no.
home
office
Fax no.
Email
Name of School/Organisation (for school programme or Social Harmony Project only)
Name of Programme*
Date of Programme* Day Month Year
(if the programme lasts for more than one day, please enter the first day of the programme)
Time*
Programme Group (if applicable)
Total no. of Participants (for family, school programme or Social Harmony Project only)
MuseKids no. (if applicable)
Parent / Guardian (Applicable to applicants under the age of 18)
Name*
Tel no.*
Relationship to the child*
*I hereby certify that all the information provided is correct and complete.
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