Fill in the below application form

Course details

Center
--- Please select --- Hampton Loft (Tai Kok Tsui)
Month

Course

Class


Child’s Information

English Name: (as stated on the birth certificate)

Chinese Name: (as stated on the birth certificate)

Sex:   Male Female

Date of Birth:  
Certificate Type:   Hong Kong Birth Certificate Other Country Birth Certificate

Certificate No.:


Parent's Information

English Name:

Contact Number:

Relationship:
--- Please select --- Father Mother Guardian
Email Address:

Course Preference
Which day(s) do you prefer for your course?
Tuesday Wednesday Thursday Friday Saturday

Which time slot(s) do you prefer for your course?
8:45-9:45 10:15-11:15 11:45-12:45 14:00-15:00 15:30-16:30

Expected Start Month
January - February
March - April
May - June
July - August
September - October
November - December

Health Condition

Does your child have any allergic disease(s) or medical condition(s) that need special attention?
Yes    No

If yes, please provides details of possible symptoms-triggering foods, materials or conditions in relation to the above mentioned allergic disease(s) or medical condition(s) of your child:

I declare that all information on this application form is true and correct and I am willing to provide relevant evidence if necessary.

Acceptance of terms and conditions
I hereby confirm that I have read and agree to be bound by all of the terms and conditions and I am ready to proceed. In case of any dispute, Little Habs reserves the right of final decision.

Personal Information Collection Statement
I understand and agree that the personal information provided by me in the application form will only be used for the purpose of processing my application by Little Habs. The personal information retained by Little Habs will be treated in accordance with the Privacy Policy of Learning Habitat. Little Habs will retain the personal information for such period as Little Habs may deem necessary for the above purpose.