Online Registration

Parent / Guardian Details

Parent/Guardian First Name:

Parent/Guardian Last Name:

Relationship to Child:
MotherFatherGuardianOther

Email:

Home Address:

City:

Post Code:

Home Tel:

Mobile (To be used for WhatsApp/SMS communication):

Emergency Contact Name:

Emergency Contact Number:

Other Notes:

Parent / Guardian Consent

From time to time Al Falaq Academy may take photographs of pupils during a lesson or at a special event, and use these images on the Academy website or other promotional material.

Do you give consent?
YesNo

Child Details

Child First Name:

Child Last Name:

Child Birth Date:

Gender:
MaleFemale

Child Current School:

Academic School Year:
ReceptionYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11

AL Falaq Islamic School provides free education for underprivileged children — would you like to support this cause?
YesNo

Medical Needs (if any)?