Raffles American School
Camp Registration

Assigned Agent (Leave blank if none)

Child Family Name

Child First Name

Child Western Name

Date of Birth

Age

Gender

Nationality

Passport Number

Copy of Passport

Please upload a clear copy of the passport. The file size should not exceed 2MB. Accepted formats: jpg, jpeg, png, pdf.

Does the child have siblings?

A sibling discount is only applicable if you select ‘Yes’ and provide details now. If you do not declare siblings on this form, the discount cannot be applied later.

Sibling(s) Name (Separated by commas)

Please provide the names of siblings, if any. Ensure spelling of names is the same as on their registration form.

Is Child Vegetarian?

Is the child boarding?

Are there any special room or classroom requests?

Camp 1 - 2025-06-30 to 2025-07-11

Camp 2 - 2025-07-14 to 2025-07-25

Camp 3 - 2025-07-28 to 2025-08-08

Camp 4 - 2025-08-11 to 2025-08-22

Language Proficiency

Child's Address in Malaysia

Languages Spoken

Shirt Size

Behavioral Concerns?

Behavioral Concerns Description

Illnesses?

Illnesses Description

Allergies?

Allergies Description

Learning Difficulties?

Learning Difficulties Description

Can the child swim?

Asthma?

Uses an Inhaler?

Hearing Issues?

Any Health Concerns?

Health Concerns Description

Medication Required?

Medication Description

If the child is feeling unwell, do you give permission for the camp nurse to administer medication?

Medication Not Allowed (if any)

Mother's Name

Mother's Email

Mother's Contact Number

Please add the country code, e.g. +60123456789

Mother's Passport Number

Mother's Preferred Chat App

Mother's Chat App Number

Father's Name

Father's Passport Number

Father's Email

Father's Contact Number

Please add the country code, e.g. +60123456789

Father's Preferred Chat App

Father's Chat App Number

Emergency Contact Name

Relationship

Emergency Contact Number

Are you interested in a tour of Raffles American School and its facilities?

I agree to the terms and conditions.

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Terms and Conditions

By submitting this registration, you acknowledge that you have read, understood and agree to our consent form and privacy policy, and you provide your consent for the processing of your child's personal data for camp participation.

Raffles American SchoolCamp Registration

Raffles American School
Camp Registration