EMC Madrasa Registration

First Name * Last Name * Student Date of Birth * Email address * Phone number * Parents Name * Street Address * Postcode * Emergency Contact Name * Relationship to Student * Emergency Contact Number * Does your child have any food allergies or any medical condition or special needs? * Photo or Video permission -I consent to having my/my child's photos/videos taken for EMC marketing purposes *

Programme Selection (Please tick all that apply) *

Qur’an for Beginners (Qaa’idah, Arabic reading & writing) Qur’an Recitation (Tajweed & fluency) Islamic Studies (Aqeedah, Hadith, Fiqh, Akhlaaq, Aadaab & Islamic History) Hifdh Programme (Full / Partial memorisation)

Select Student School Year Group * Select an option Nursery Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 I confirm that the information provided is accurate to the best of my knowledge. I understand that my child will be expected to follow the madrasah rules, respect teachers, and maintain good conduct at all times *