Beaconhouse School System Mirpur

Registration fee
Registration Form
Rs.1000/-

Registration # Date of registration: ______________________

Name of student: _________________________________________________________________________

Parent / Guardian Name: ____________________________________________________________________

Email address (Parent/Student):_______________________________________________________________

Level: Early Years Primary Middle Class: -------------------- Age:______ years

School / Institution Name: ___________________________________________________________________

Address: __________________________________________________________________________________

Contact No: _______________________________ Emergency Contact #: ___________________________

Does your child suffer from any allergies, illness, disability or other medical conditions? If yes, please detail
below: Yes No

Detail:____________________________________________________________________________________

Cash Received Rs. 1000/- from Mr/Mrs ________________________________________________________

Parent /Guardian of ________________________________________for Class _______________________

Parent/Guardian Signature: ______________________ Registered by: __________________________

…………………………………………………………………………………………………………………………………………………………
Bring this registration slip along with you.
Registration Form for Summer Adventures 2k19
Level: _________________________ Registration #:

Name of Student: ______________________________________________ Contact Number: 05827-444660

Amount Paid: Rs.1000/- Date: _______________________________

Registered by: __________________________