Register - Al Hikmah School

✓ Registration Submitted Successfully!

Thank you for registering. We will contact you shortly.

Child Information

First Name*

Middle Name

Last Name*

Date of Birth*

Gender*

Boy Girl

Medical Conditions

Allergies (Specify):

Asthma:

Other (Specify):

Regular Medication (Specify):

Any Learning Disabilities:

Family Information

Father's Full Name*

Mother's Full Name*

Address

House Number & Street*

Town*

Postcode*

Tel (Home):

Tel (Mobile)*

Whose number is this?*

Tel (Mobile):

Whose number is this?

Email Address(es)*

Miscellaneous

Any other information we should know about:

Where did you hear about us?

Signature

Name*

Signature*

Date*

Note: Please ensure all information is accurate. Fields marked with * are required. We will contact you within 2-3 business days to confirm your registration.

Student Registration

✓ Registration Submitted Successfully!

Child Information

Family Information

Miscellaneous

Signature