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SUMMER SCHOOL PROGRAMME 2026 Health Declaration

Welcome to King Henry VIII College, Malaysia!
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Update of Contact Details

Student's Details

Parents' Details

Documents Uploads

1. Passport of Student (JPEG/ PNG/ PDF)

2. Passport of Parents (JPEG/ PNG/ PDF)

[I] Health Declaration

(A) Medical Information

1. Does your child have any known medical condition?

1. Does your child have any known medical condition?
A
B

2. Does your child require medical treatment or medication?

2. Does your child require medical treatment or medication?
A
B

3. Does your child wear glasses or contact lenses?

3. Does your child wear glasses or contact lenses?
A
B

4. Does your child have any hearing difficulties?

4. Does your child have any hearing difficulties?
A
B

5. Does your child have any allergies?

5. Does your child have any allergies?
A
B

6. Does your child have any allergies to medication?

6. Does your child have any allergies to medication?
A
B

Please note that there must be an English translation, certified by a doctor for any medication brought. This must be handed to the staff on duty upon arrival at King Henry VIII College.
If you have answered YES to any of the above, please provide further details below. Also, indicate clearly whether this condition will, in your opinion, affect your child’s ability to participate in any summer camp related activities and/or summer camp outings.

(B) Dietary Requirements

Does your child have any dietary requirements?

Does your child have any dietary requirements?
A
B

(C) Medical Treatment Consent/Declaration

If your child should require any form of medication and/or medical treatment whilst on this school trip then we will do all that we can to contact you for any decisions that need to be made. If, however, we are unable to contact the named individuals or there is insufficient time, the advice of the medical authorities present will be taken. By signing and submitting this consent form, the student’s parents or guardians indicate their consent to this.

Declaration :

I hereby agree to my child receiving medication as instructed, or any emergency or surgical treatment as considered necessary by the medical authorities present. I confirm that the information given above is accurate to the best of my knowledge.

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