EKISAAKATE
Settings
Activity Log
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EKN
Dashboard
EXIT
PARTICIPANT'S INFORMATION
Name:
Age
Gender:
Select gender
Male
Female
School:
Class:
Select Class
BABY
TOP
MIDDLE
PRIMARY ONE
PRIMARY TWO
PRIMARY THREE
PRIMARY FOUR
PRIMARY FIVE
PRIMARY SIX
PRIMARY SEVEN
SENIOR ONE
SENIOR TWO
SENIOR THREE
SENIOR FOUR
SENIOR FIVE
SENIOR SIX
Clan:
Does your child have a personal Doctor
YES
NO
Doctor's Name
Doctor's contact
Will your child need to take any prescribed medication while at Ekisaakaate Kya Nnabagereka?
Yes
No
Does your child have any allergy?
Yes
No
Food
Medicine
OTHER
Insects
Special activities to be restricted for health reasons:
Is this the participant's first time to attend ekisaakaate?
Yes
No
Please specify which years.
Any special issues you want to be addressed during the EKN program?
(In relation to your child)
: