Current date * How many student do you want to register for?* —One studenttwo studentsThree students [group group-544] First student informations First Name * Last name * Full name in Arabic Date of birth * Place of birth* Gender* MaleFemale Address* Apt: City * Province * Postal code* Health card number * Expiry date * Does the student have any medical conditions? * YesNo If yes, please explain Does the student take any medication? * YesNo If yes, please explain Does the student has any alergy? YesNo If yes please explain [/group][/group] [group group-2ndstinformation] ———————————- First student informations First Name * Last name * Full name in Arabic Date of birth * Place of birth* Gender* MaleFemale Address* Apt: City * Province * Postal code* Health card number * Expiry date * Does the student have any medical conditions? * YesNo If yes, please explain Does the student take any medication? * YesNo If yes, please explain Does the student has any alergy? YesNo If yes please explain ————————————————————————— Second Student informations First Name * Last name * Full name in Arabic Date of birth * Place of birth* Gender* MaleFemale Address* Apt: City * Province * Postal code* Health card number * Expiry date * Does the student have any medical conditions? * YesNo Please explain Does the student take any medication? * YesNo Please explain Does the student has any alergy? YesNo If yes please explain [/group] ———————————– [group group-3rd] First student informations First Name * Last name * Full name in Arabic Date of birth * Place of birth* Gender* MaleFemale Address* Apt: City * Province * Postal code* Health card number * Expiry date * Does the student have any medical conditions? * YesNo If yes, please explain Does the student take any medication? * YesNo If yes, please explain Does the student has any alergy? YesNo If yes please explain Second Student informations First Name * Last name * Full name in Arabic Date of birth * Place of birth* Gender* MaleFemale Address* Apt: City * Province * Postal code* Health card number * Expiry date * Does the student have any medical conditions? * YesNo if yes, please explain Does the student take any medication? * YesNo Please explain Does the student has any alergy? YesNo If yes please explain Third student information First Name * Last name * Full name in Arabic Date of birth * Place of birth* Gender* MaleFemale Address* Apt: City * Province * Postal code* Health card number * Expiry date * Does the student have any medical conditions? * YesNo if yes, please explain Does the student take any medication? * YesNo if yes, please explain Does the student has any alergy? YesNo If yes please explain [/group][/group] Primary parent informations First name Last name Phone Number Relationship to the student MotherFather Email Emergency contact informations First Name Last Name Address City State / Province / Region Phone Email Photo and video consent form I hereby give my consent to Amjad Islamic school to use and broadcast any photographs /video/audio of my minor child on the official Amjad Islamic school website and on other official sites: YouTube Channel, Facebook, as well as for media purposes, including promotional presentations and advertising campaigns. In addition, I waive all claims to compensation or damages based on the use of his/her image/voice by the school. I also waive any right to inspect or approve the finished works. I agree that all such works and any reproductions shall remain the property of Amjad Islamic school unless otherwise noted. AgreeDisagree Please read and confirm that you understand and accept the school rules and policies Accept
