Application Form-Playgroup - Mount Kelly Hong Kong Page 2

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Application Details
I) Babies bumblebees (6 to 11 months)
Session
Fee
Monday
Tuesday
Wednesday
Thursday
Friday
Once a week
$1,100 /
*Tick any 1
month
box
(9:30–10:30am)
(9:30–10:30am)
Twice a week
$1,750 /
*Tick any 2
month
boxes
(2:00–3:00pm)
II) Toddling Hedgehogs (12 to 18 months)
Session
Fee
Monday
Tuesday
Wednesday
Thursday
Friday
Once a week
$1,100 /
*Tick any 1
month
box
(9:30–10:30am)
(11:00–12:30pm)
(9:30–10:30am)
Twice a week
$1,750 /
*Tick any 2
month
boxes
III) Pre-Two Badgers (19 to 24 months)
Session
Fee
Monday
Tuesday
Wednesday
Thursday
Friday
Once a week
$1,200 /
*Tick any 1
month
box
(11:00–12:30pm)
(9:30–11:00am)
(11:00–12:30pm)
Twice a week
$2,300 /
*Tick any 2
month
boxes
Three a week
$3,400 /
*Tick any 3
month
boxes
IV) Pre-Three Red Deer (25 to 36 months)
Session
Fee
Monday
Tuesday
Wednesday
Thursday
Friday
Twice a week
$3,000 /
*Tick any 2
month
boxes
(11:00am–1:00pm)
(11:00am–1:00pm)
Three a week
$4,250 /
*Tick any 3
month
boxes
(2:00–4:00pm)
(2:00–4:00pm)
 as appropriate (Actual Class Hours will be subject to place availability, school office will further confirm with parents)
Signature and Declaration
I declare that the information provided is true, complete and accurate. I provide permission to Mount Kelly School Hong Kong to seek medical assistance for my child
in the event of an emergency and I will bear full financial responsibility for any cost incurred.
I understand and agree with all the Terms and Conditions for the programme.
I provide permission to use images of my child participating in school activities for promotional material such as advertisements, videos, websites and other social
media.
Signature:
Relationship to applicant:
Date:
The data collected in this form will be used and stored in accordance with the provisions of the Personal Data (Privacy) Ord. Cap. 486 of Hong Kong.
For Office Use Only:
Application Checklist
Completed application form
Parents/guardians HKID or passport
Applicant’s birth certificate
Address Proof
Administrative Fee of $500

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