December 2022 School Holiday Workshop 
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Email *
I would like to sign up for the following holiday workshops:  *
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I would like to sign up for the following workshop:  *
I would like to sign up for the following session:  *
Name of child *
Current student at Mosaic Preschool
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Date of birth *
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DD
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Gender *
Name of parent *
Email address *
Contact number *
Registration Payment: I understand that there will be no waiver or refund made to the school fee for absenteeism due to any reasons, and fees will have to be paid in full. *
Consent to the use of child’s photograph and video: I give consent to Mosaic play academy to use my child’s photograph/video for the purpose of Mosaic’s marketing and promotional materials. *
Medical Authorisation: I hereby authorise the school to seek any medical attention/advice which my child may require, when the pediatrician/family doctor or myself cannot be contacted. All the medical costs will be borne by the parents unless stated otherwise. *
Other school policies: I agree and will comply with all the rules and regulations as discussed with the school management. *
How did you find out about the programme? *
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