Al-Bayan Arabic School

Father’s name:

Mother`s name:

Phone (Father’s mobile):

Mother’s Mobile:

City:

State:

Post Code:

STUDENT INFORMATION

First Name:

Last Name:

Age:

D.O.B:

Name of School child attends:

Current School Level:

Please select day of attendance:

Monday 5-8pmWednesday 5-8pmThursday 5-8pmSaturday 10am-2pm

EMERGENCY CONTACT INFORMATION

Name and relationships to child:

Mobile:

Name and relationships to child:

Mobile:

Medical Conditions

Does your child suffer from any of the following?
o Asthma YESNO
o Anaphylactic reactions YESNO
o Diabetes YESNO
o Food Allergies YESNO
o Special dietary requirements YESNO
o Any other conditions?Yes

Does your child require any medications or an action plan?
If yes, please provide an action plan and any other equipment required. i.e. A puffer, spacer, or Epi-pen.

STUDENTS PICK UP AND DROP OFF.

Al bayan community language school is not to be held responsible for the sign out of students from school. It is the parents/guardian responsibility to attend school to drop off and pick up their children from school in accordance with school timetable and any organised activities.

PHOTO CONSENT

I dodo not give permission for my son/daughterto have their picture taken either for display or for the purpose of advertisement for Al-Bayan through our face book account or other social media.

Use of Personal Information

You may correct any personal information provided at any time by contacting Al-Bayan Institute.

Parents Signed

Date

DECLERATION

I HAVE READ AND UNDERSTOOD THIS ENROLMENT FORM. I UNDERSTAND THAT MY CHILD IS EXPECTED TO TAKE THIS PROGRAM SERIOUSLY AND DRESS AND BEHAVE APPROPRIATELY AND SAFELY.

Note: Parents who decide to withdraw their children from school must fill the exit/short return form stating when they will be stopped. Please note that we will need to be informed two weeks prior to the stopping date to avoid paying the full-term fee.

PARENTS SIGNATURE

DATE

Teaching Children Islamic Knowledge

REGISTRATION FORM 2025

FAMILY INFORMATION