Registration Form

Main Information

Child’s Full Name *

Date of Birth *

Child’s Full name in Arabic *

Gender *

MaleFemale

Parent/Carer Name *

Mobile Number *

Email Address *

Home Address *

Religion

Arab country of origin *

One other Emergency contact name & phone number*

Security Collection Details

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.

Collectors Full Name *

Relationship to the Child *

Contact Number *

Password *

Health Declaration and Emergency Contact Details

In any case of emergency do we have permission to seek medical advice for your child? *

YesNo

Details of any Known allergies *

Details of any current/ongoing Prescribed medication *

Any specific dietary requirements? Please state *

Doctors Name, Number and full Address

Any other Information you wish to add about your child

Yasmeen Arabic classes & clubs

Kindly Choose Term *

Arabic classes for the ages(3-5 years old)

Kindly Choose your Class Preference *

Kindly choose time slot *( For ages 3-5 years old)

Arabic classes for the ages(6-12 years old)

Kindly Choose your Class Preference *

Kindly Choose Payment *

One year subscription on Kutubee App https://www.kutubee.com/ (an Interactive Reading Platform which contains more than 1500 carefully selected Arabic books for all reading stages)

YesNo

Permissions

We hereby give permission for Yasmeen Arabic Language Centre to take photos of our child to use within the school for displays, artwork etc… *

YesNo

We hereby give permission for our child’s photo to be used in advertising such as Yasmeen Arabic Language Centre Website, local newspapers etc. *

YesNo

We hereby give permission for staff to administer prescribed medication or calpol provided by the parent/carer with written consent. *

YesNo

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. *

YesNo

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. *

YesNo

Questions to help us get to know your child

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?