Miracle Kidz Care - Registration

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Parent/Guardian Information

First Name* Last Name* ID Number* Residential Address* Postal Address Email Address Phone Number* Home Number Work Number Occupation Work Address Gender
Male Female

Marital Status
Single Married Divorced Widowed

Religion Church Church Leader

Child Information

Child's Name* Child's Surname* Name Called at Home Child's Age* Child's Gender*
Male Female

Child's Date of Birth* Child's ID Number* Who will bring your child to school?* Who will fetch your child from school?* NB: For security purposes, please note that we need a photocopy of the above mentioned persons ID document to keep on file and that no one else will be permitted to fetch your child from school under any circumstances.
No family member or friends will be permitted to visit children during school hours, or remove children from premises without a validated reason authorised by the parent or guardian.*

Other Children from Family A discount of R40 will be given per child

Medical Information

Doctor's Name* Contact Number* Medical Card Number Does your child have any allergy?*
Yes No

If yes, Specify* Does your child have medical condition?*
Yes No

If yes, Specify*

I read the Terms and Conditions

Contact Details

Cellphone: 082 826 4157
Cellphone: 073 626 2674
Email: info@miraclekidzcare.co.za

791 Kgotso Street
Vleifontein
Makhado
0920

Our Programs

Infant Care
Butterfly Class
Grade RR

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