TDCC Summer Camp 2025 Registration

Child's Name

First NameLast Name

Date of Birth

Date

Address

Mother

NamePhone Number

Father

NamePhone Number

Contact Email Address

example@example.com

Dietary Requirements

Medical Condition: The following special health problems should be noted and adequate precautions taken (list such items as: usually severe reactions to bee stings, other severe allergies, haemophilia, diabetes, heart disease, etc.)

Rows	Health Issue	Reaction	Medical Response required
1
2

If medication is required to be administered by a Centre nurse, during Centre hours, a duplicate copy of the prescription is mandatory. The following medication/ prescription is required:

Rows	Medical Prescription	Dosage	Time	Specific Instructions
1
2

Drop off/ collection from TDCC:

Rows	Name	Phone number	Relation to the Child
1
2

Emergency Contact

Rows	Name	Phone number	Relation to the Child
1
2

Language spoken at home

First language

Is your child dry during the day?

Can your child feed themselves?

Does your child attend nursery or school?

If yes, name of nursery or school?

Write N/A if not applicable

Does your child have a diagnosis?

If yes, kindly specify:

Write N/A if not applicable

Grade level?

Type of program

Services Received at School (if any):

Does your child see any health professionals?

If yes, type of health professional

How is your child's behavior at nursery / school?

How is your child behavior at home?

How do you manage the behaviors?

What would you like us to focus on during the program?

List of preferred activities?

List of activities to avoid? (messy play , water play , bubbles, etc)

Does your child talk? (verbal)

If no, how does your child communicate:

Please check your registration options (Mon - Thu 9 am to 1 pm and Fri 9 am to 12 pm) :

Weekly rate: AED 1800 per child

Terms and conditions: Fees are due within five days of receipt of registration. This fee is not refundable.

How did you hear about the program?

Name and Signature