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Teens aLIVE Holiday Camp September 2016 Registration Form
Thank you for your interest!

For payment, you may come down to our front desk during our opening hours or alternatively, you may execute a bank transfer to our bank. For inter-bank transfer, here are our account details:

Bank : OCBC (Current)
Bank Acc No : 581 738 44 0001
Bank Code: 7339
Branch Code: 581
Acc Name : LPM Al Falah
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Full Name *
Date Of Birth *
MM
/
DD
/
YYYY
NRIC Number *
Residential Address *
Contact Number *
Email Address *
Participant's Medical Condition *
State all Allergies or injuries. If you do not have any, type 'NIL' in the box below.
Parent/Guardian's Full Name *
Either of your parents or Guardian's Full Name
Parent/Guardian Email Address *
abc@gmail.com (Either parent/guardian)
Parent/Guardian NRIC Number *
SXXXXXXXZ (Parent/Guardian)
Parent/Guardian Contact Number *
Handphone Number
School *
Name of the School you are currently in?
What school level are you in? *
What stream are you in currently? *
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