2018-2019 Weekday Maktab Registration
Please provide information to register your child for 5-7 Maktab Monday to Friday at Masjid Al-Baqi
Student Information
Child 1 Name *
Your answer
Child 1 Gender *
Child 1 Date of Birth *
MM
/
DD
/
YYYY
Child 2 Name
Your answer
Child 2 Gender
Child 2 Date of Birth
MM
/
DD
/
YYYY
Child 3 Name
Your answer
Child 3 Gender
Child 3 Date of Birth
MM
/
DD
/
YYYY
Child 4 Name
Your answer
Child 4 Gender
Child 4 Date of Birth
MM
/
DD
/
YYYY
Allergies to medication (Any Child)
Mention Allergies any of your child(ren) have for Emergency reasons
Your answer
Food Allergies (if any)
Your answer
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