Parents First name *

Parents Last name *

Parent Email address *

Phone *

Whatsapp Number *

Child's Name *

Child's Gender *

Age *

I/We acknowledge & understand that the Residential Program "The True North" runs from 8th May 2022 to 14th May 2022 and can't be held responsible for my ward's whereabout outside the program days *

I/We allow my ward for Residential program for 7 days & nights *

Is Child Allergic to anything or under any Medication? If Yes, please provide the details. (optional)

Any other important information about the child you want to share. (optional)