Umar Masjid Maktab Registration Form

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Is your child currently registered in the Umar Masjid Maktab?* This field is required.
YESNO
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Parent/Guardian Information* This field is required.
Full Name
Contact Number
Email
Father/Guardian
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Mother/Guardian
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Father/Guardian
Mother/Guardian
Full Name
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Contact Number
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Email
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Full Name
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Contact Number
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Email
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Phone Number* This field is required.Please enter a valid phone number.
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Student's Name* This field is required.
First Name
Last Name
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Date of Birth* This field is required.
Date
Year
Month
Day
7
Student's Grade in 2025-26 School Year
Please Select
Please Select
SK
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
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Student Gender* This field is required.
Please Select
Please Select
Male
Female
9
Healthcard Number* This field is required.In the event of an emergency, we may need this information.
10
Please list any allergies or medical conditions* This field is required.List all allergies
11
Emergency Contacts* This field is required.Require at least one emergency contact separate from parent/guardian
Full Name
Contact Number
Relationship with student
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Full Name
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Contact Number
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Relationship with student
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Full Name
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Contact Number
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Relationship with student
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Does your child have any Special Education Needs?* This field is required.Eg. ADHD, IEPs, BSP, etc.
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Large
Normal
Small
Ok
Ok
13
Terms and Conditions* This field is required.Terms and Conditions By submitting this form, you agree to the following terms: Registration Registration is conditional upon availability at the appropriate level for your child(ren). Monthly Payments - Payments will be automatically withdrawn from your bank account on the 25th of every month, regardless of the date of registration within that month. - Payments will continue during Ramadan and the summer months. There is no option to pause enrolment during these periods. Cancellation Policy - To cancel enrolment, a Cancellation Request Form must be submitted before the 1st of the month to avoid being charged for the upcoming month. - The form is available upon request. - It is the parent’s responsibility to submit the cancellation request on time. Resource Fee A one-time resource fee of $30 (cash only) is due during the first week of enrolment. Refund Policy No refunds will be issued. Student Conduct All students must abide by all Maktab policies and regulations. Failure to do so may result in removal from the program and forfeiture of all payments. Liability for Damages Any damages caused by your child(ren) to the property of MAH or its staff will be your financial responsibility.
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My Products* This field is required.
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Umar Masjid Maktab
The total cost per month is $41.52 CAD, which includes processing fee. Payments can be made using Debit OR Credit VISA, Mastercard, AMEX.
$41.52CAD for each month
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