Parent/guardian details
Name of child: Bernard Kerere
Parent(s)/Guardian(s) details
Parent/Guardian 1
Name: Judith Kerere (mother) Country of birth: Uganda Language/s spoken: English Occupation: Secretary Is the work undertaken by this person paid or voluntary? PaidParent/Guardian 2
Name: Harold Kerere (father) Country of birth: Uganda Language/s spoken: English Occupation: Student Is the work undertaken by this person paid or voluntary? Nil (student)Do either (or both) parent(s)/guardian(s) have a disability? No
Custody of the Child
Have any orders been made by any court regarding your child? If “No”, is there any dispute/s concerning custody of the child? If “YES”, please provide details of Guardianship and Custody, and Terms of any specific Custody or Access provision (if applicable): Permanent custody of Ben with open visitation rights of family.
Enrolling parent/guardian's initials:
Date: