Child’s Full Name *
Date of Birth *
Child’s Full name in Arabic *
Gender *
Male Female
Parent/Carer Name *
Mobile Number *
Email Address *
Home Address *
Religion
Arab country of origin *
One other Emergency contact name & phone number *
Next
We only allow authorised adults to collect your child with prior notice from you on the day in question. By giving us the details below Yasmeen Arabic Language centre assume that you give consent for collection of your child from the named substitutes below.
Collector's Full Name *
Relationship to the Child *
Contact Number *
Password *
In any case of emergency do we have permission to seek medical advice for your child? *
Yes No
Details of any Known allergies *
Details of any current/ongoing Prescribed medication *
Any specific dietary requirements? Please state *
Doctor's Name, Number and full Address
Any other Information you wish to add about your child
Kindly Choose Term *
-- Select Term -- Autumn term Spring term Summer term
Kindly Choose your Class Preference *
-- Select Preference -- Explorers ( For 3 Yr ) Incredibles (For 4 Yr) Beginners (For 5 Yr)
-- Select Preference -- Foundation 1 (6-7 Yr) Foundation 2 (7-8 Yr) Year 1 (A) (8-9 Yr) Year 1 (B) (9-10 Yr) Year 2 Year 3 GCSE Preparation
Kindly Choose your Club Preference * (For ages 6-12 years old)
Kindly Choose Payment *
-- Select Payment Option -- Per term Full year
One year subscription on Kutubee App *
We hereby give permission for Yasmeen Arabic Language Centre to take photos of our child to use within the school for displays, artwork etc… *
We hereby give permission for our child’s photo to be used in advertising such as Yasmeen Arabic Language Centre Website, local newspapers etc. *
We hereby give permission for staff to administer prescribed medication or calpol provided by the parent/carer with written consent. *
We hereby give permission for Yasmeen Arabic Language Centre to take our child off the premises to go for a walk in the woods, to the shops, to the park or library etc. *
We hereby give permission for Yasmeen Arabic Language Centre to allow our child access to the school’s computer and internet facilities, with supervision from school practitioners. I understand that all internet sites will be suitable for the age range of the children in the room. *
What does your child enjoy playing with?
Is there any likes or dislike that your child has?
Are there any ways in which your child might need help/ support from a member of staff?
How did you hear about us?
