Children Wellness Program 2019

Please note, you can apply for one child only.

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* 1. 1st Parent/Guardian's details

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* 2. Your mobile number without the initial zero

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* 3. 2nd Parent/Guardian's details

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* 4. Your mobile number without the initial zero

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* 7. In case of emergency please contact

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* 9. Living arrangements

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* 10. Child's details

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* 12. Any medical conditions that facilitator needs to be aware of?

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* 13. Any educational challenges that facilitator needs to be aware of?

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* 14. Allergies or dietary restrictions?

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* 15. Please list siblings details (Optional)

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* 18. I give permission for my child photos to be shared on KAUST social media accounts, FB, Instagram, and KAUST Health websites.

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