Cavenur Student Care Registration Form                                  
For school-age going students: 7 to 14 years.
Please fill in this form to register your child. It might take 20 mins to complete.
Please note that you have submit the following documents to our email: cavenur.edv@gmail.com
1) A copy of your child’s Birth Cert                
2) Front and back copies of both parents’ NRIC

Incomplete registration form will not be accepted and processed.
For more enquiries, please call at 6721 9591 or email at cavenur.edv@gmail.com
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Student’s Particulars
Name of Students *
Birth Cert No. *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Address *
Citizenship *
Race *
Religion *
School *
Class *
Year *
Medical History of Students
Medical Conditions *
Yes
No
Periodic Loss of Consciousness
Heart Condition
Ear Disorder
Asthmatic Bronchitis
Epileptic Fits
Febrile Fits (Related to fever)
Skin Disease
Others
Please specify if ‘yes’ for the above question.
Is your child allergic to any drugs, food or others? If yes, please specify.
Other Conditions
Does your child have the following conditions that we should be aware of? *
Yes
No
ADHD
ADD
Dyslexia
Dyspraxia
Autism
Others
Please specify if ‘yes’ for the above question.
Father's Particular
Father’s Name *
NRIC *
Nationality *
Race *
Religion *
Tel (Home)
Tel (Mobile) *
Tel (Office)
Occupation *
Email *
Marital Status *
Mother’s Particular
Mother’s Name *
NRIC *
Nationality *
Race *
Religion *
Tel (Home)
Tel (Mobile) *
Tel (Office)
Occupation *
Email *
Marital Status *
Emergency Contact (apart from Parent)
In case of emergency, please contact the following person(s):
Emergency Contact 1
Name *
Relationship to child *
Tel (Mobile) *
Tel (Home)
Tel (Office)
Emergency Contact 2
Name
Relationship to child
Tel (Mobile)
Tel (Home)
Tel (Office)
The following person(s) other than parents will be allowed to fetch my child home:
Contact 1
Name *
Relationship to child *
NRIC *
Phone no.: *
Contact 2
Name
Relationship to child
NRIC
Phone no.:
Declaration of Financial and Alternative Care Options
My child has alternative care options for 2020. *
If yes, alternative care options available (Please tick accordingly)
For those who select "Grandparents" as alternative care options, are they staying in the same household?
Clear selection
Gross Household Monthly Income (before CPF deductions) *
Total number of household members *
Fetching arrangement for child from student care centre: (Please tick accordingly) *
Required
For those who select "Grandparents" as one of the fetching arrangements, are they staying in the same household?
Clear selection
Submit
Clear form
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