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Read & Rise Club 

After School Qur'an Club

REGISTRATION FORM

(ONE BOOKING FORM PER FAMILY) ADDITIONAL BOOKING FORMS AND / OR FURTHER INFORMATION PLEASE VISIT OUR OFFICE
Registration Form must be completed in FULL (LIMITED SPACES) PLACES GIVEN AFTER FULL PAYMENT ON A FIRST COME FIRST SERVE BASIS

Parent/Guardian Details

PLEASE USE BLACK INK AND BLOCK CAPITALS THROUGHOUT THIS FORM)

Title:

Forenames:

Surname:

Address:

Postcode

Email:

Tel:

Mobile

Occupation

Husband/wife's name

Phone Number

Children's Details

Child 1

Gender

Child 2

Gender

Child 3

Gender

Child 4

Gender

Child 5

Gender

Emergency Contacts

PLEASE GIVE THE NAMES OF TWO PERSONS WE MAY CONTACT IN CASE OF AN EMERGENCY:

Contact 1

Contact 2

Names of Collectors

PLEASE GIVE THE NAMES OF PERSONS WHO MAY / WILL BE COLLECTING YOUR CHILD/REN AT 6.00PM:

Payment information and Policy

£480 per a child, for the full academic year.

Once a child is registered in the Qur’an Club, fees must be paid in full, regardless of the fact whether she / he attends all lessons or only a few lessons. The fee is NOT REFUNDABLE.

PLEASE CHOOSE HOW YOU WOULD LIKE TO PAY THE FEES 

1) By cash 

2) By Bank transfer 

Name of the Bank: RBS 

Name of the account: Iron Aid Foundation 

Account number: 11157159 

Sort code: 16-33-45 

Please use your child’s name & date of birth as a reference

Name

Signature

Medical Information


PLEASE PROVIDE ALL MEDICAL CONDITIONS MENTAL OR PHYSICAL. ALSO INCLUDE ALLERGIES AND ANY OTHER CONDITIONS AND REQUIREMENTS

Child 1

Gender

Medical Condition

Medical Condition

Child 2

Gender

Medical Condition

Medical Condition

Child 3

Gender

Medical Condition

Medical Condition

Child 4

Gender

Medical Condition

Medical Condition

Child 5

Gender

Medical Condition

Medical Condition

Please give any further information that you consider we may need

Reminder: Places are awarded on a first come first serve basis.