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Application Form for
Childcare Provision
Parent / Guardian Details
Include Secondary Parent / Guardian details
Child
Details
Date of Birth *
Gender
Male
Female
Do you give permission for your child to leave the school premises independently?
No
Yes
Does your child have any medical conditions the organisation should be aware of?
Child
- Which Course are you applying for?
Qur'an, Hifz, Duas, Hadith & Islamic Studies - Weekday classes
Arabic Language - Weekend classes
Both
Child
- Medical Practice
Child
- Emergency Contact
I have read and understood the
Fee Policy
and agree to abide by its Terms and Conditions.
I have read and understood the
E-Safety Agreement
and discussed this with my child(ren).
Submit
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