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Child's Full Name *

GenderGenderMaleFemale

Date of Birth

Which grade will your child start in August 2024:Kindergarten1st Grade2nd Grade

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

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Primary Language Spoken at Home: *

Does the child have any medical conditions or allergies? If yes, please specify: *

Previous School Name

How important would afterschool programming (3pm-5pm) be in order to send your child to Rahma Academy? (Please check a box)Extremely importantIt would be helpfulNot necessary

Parent/Guardian Information

Email *

Phone

Pick-up Authorization: (List individuals, besides parents/guardians, who are authorized to pick up the child from school)

Consent and Agreements:

Signature of Parent/Guardian:

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