Child Information

School Information

—Please choose an option—Krugersdorp High SchoolHoërskool Jan De KlerkCurro Krugersdorp High SchoolTownview High SchoolKrugersdorp Town SchoolMonument Primary SchoolLaerskool MillenniumSilverfields Primary SchoolLaerskool Krugersdorp NoordCurro Krugersdorp Primary SchoolSt Ursula's SchoolAlma Mater International SchoolAlma Mater Primary SchoolOther

Pickup Details

Parent / Guardian Information

Emergency Contact (Other than Parent)

Medical Information

Consent & Notes

I confirm that the above information is accurate and can be used in case of emergency.