Child's Details

How many of your children are enrolled in Madrasah Nasihah? *

Child 1

First Name *

Last Name *

Date Of Birth *

Gender *MaleFemaleSelect the gender of your child

Class *Please select the class that your child is in

Medical conditionsPlease write down any illnesses or allergies that your child has. If there are none, then leave this field blank

Child 2

First Name *

Last Name *

Date Of Birth *

Gender *MaleFemaleSelect the gender of your child

Class *Please select the class that your child is in

Medical conditionsPlease write down any illnesses or allergies that your child has. If there are none, then leave this field blank

Child 3

First Name *

Last Name *

Date Of Birth *

Gender *MaleFemaleSelect the gender of your child

Class *Please select the class that your child is in

Medical conditionsPlease write down any illnesses or allergies that your child has. If there are none, then leave this field blank

Child 4

First Name *

Last Name *

Date Of Birth *

Gender *MaleFemaleSelect the gender of your child

Class *Please select the class that your child is in

Medical conditionsPlease write down any illnesses or allergies that your child has. If there are none, then leave this field blank

Street Address *

City *

Postal Code *

Parent/Guardian Details

Parent/Guardian 1

Relationship to child(ren) *Please select what your relationship to your child(ren) is

First Name *

Last Name *

Address same as child? *YesNo

Street Address *

City *

Postal Code *

Phone Number *

Email Address *

Primary Contact *YesNoPlease select 'Yes' if this is the primary contact who we should contact on a regular basis. If more than one contact is a primary contact, then select 'Yes' on both.

Parent/Guardian 2

Relationship to child(ren) *Please select what your relationship to your child(ren) is

First Name *

Last Name *

Address same as child? *YesNo

Street Address *

City *

Postal Code *

Phone Number *

Email Address *

Primary Contact *YesNoPlease select 'Yes' if this is the primary contact who we should contact on a regular basis. If more than one contact is a primary contact, then select 'Yes' on both.

Emergency Contacts

This must be someone other than the parents who can be contacted in case the parents are unreachable.

Emergency Contact 1

First Name *

Last Name *

Relationship to child(ren) *Please write down the relationship that you have with the child(ren)

Phone Number *

Emergency Contact 2

First Name *

Last Name *

Relationship to child(ren) *Please write down the relationship that you have with the child(ren)

Phone Number *

Medical Information

Doctor's Surgery Name *

Doctor's Surgery Contact Number *

Photo consent *I consentI do not consentMadrasah Nasihah may capture memorable moments of our students during various activities and may utilise these images for promotional material, presentations, and other activities aimed at highlighting our initiatives.

Contact Update Form

Child's Details

Child 1

Child 2

Child 3

Child 4