2025–2026 Student Registration Form

2025–2026 Student Registration Form
Section 1: Parent/Guardian Information

Please enter your contact information. We will use this to reach you about your child’s registration.
Full Name (Required)*

First NameLast Name
Relationship to Student(s) (Required)*

MotherFatherLegal GuardianOther
If you selected “Other,” please describe your relationship to the student(s):(e.g., Aunt, Uncle, Family Friend, Legal Guardian)
Parent/Guardian Number (Required)*
Please enter a valid phone number.
Parent/Guardian Email (Required)*
example@example.com
Parent/Guardian Address (Required)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Section 2: Student Information

Please enter details for each child you want to register. Click “Add Row” to enter more than one.
Please enter your child’s information below.
To choose a birth date, click the calendar icon and use the arrows to go back to the correct year.
We’re sorry for the inconvenience — we are working on improving this soon, Insha’Allah.
Click “Add Another” if you are registering more than one child.
Section 3: Program Confirmation

Full-Time Program Confirmation - By filling out this form, you are registering your child(ren) for our full-time educational program. This includes all subjects: Qur’an, Arabic, Islamic Studies, and core academic classes. Classes are held Monday through Thursday, 7:30 AM to 2:30–3:00 PM.
Do you understand and agree that this registration is for our full-time program only?*

Yes, I understand and agree.
Section 4: Basic Medical Information

Please let us know if your child has any allergies, medical conditions, or other important health needs. This helps us ensure your child’s safety and comfort.
Does your child have any allergies, medical conditions, or important health needs we should be aware of?
Section 5: Additional Notes & How You Heard About Us

You may share any questions, comments, or important information you'd like us to know. Then let us know how you heard about our institute.
Additional Comments (Optional) - Do you have any questions, concerns, or anything you’d like us to know before we contact you?
How did you hear about Taubah Academy? (Optional)
Section 6: Agreement & Payment

To complete this registration, you must agree to the terms and submit the non-refundable registration fee. This fee covers textbooks and technology costs and helps reserve your child’s seat.
I understand and agree to the following:
- This form is for full-time program registration.
- A staff member will contact me to complete the enrollment process.
- The 2025–2026 Registration, Technology, & Textbooks Fee is now $480.
  - The registration portion ($100) is refundable only if the enrollment process is stopped before completion.
  - The Technology & Textbooks portion ($380) is refundable only if materials have not yet been ordered.
  - If registration is stopped after materials are ordered, only the $100 registration fee may be refunded.
- My child is not fully enrolled until all steps of the process are completed.
Yes, I agree to the terms above.
How would you like to submit your registration payment?

Please note: Registration is not considered complete until payment is received.
Choose one:*

Stripe (Credit/Debit Card – pay online)ZelleIn person (Cash, Check, or Card at the front desk)
You chose to pay by Zelle.
Please send your payment to this number: (678) 900-2555.
The current registration fee is $480 per student.

In the Zelle message, please write:

Your full name
Your child’s name(s)

Note: Your registration is not complete until we receive your payment.
You chose to pay in person (Cash, Check, or Card).
The registration fee is now $480 per student.
Our office will be open for payments from June 9th to July 31th, during Summer Program hours:
11:00 AM – 2:00 PM, Monday through Wednesday

Note: Your registration is not complete until you come to the office and make your payment.

My Products

2025-26 Registration, Tech, & TextbooksEarly Registration, Tech, & Textbooks Discount is only available from May 8 thru June 8. If applying for more than one student, please change quantity.

$480.00 Quantity
Item subtotal:$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Section 7: Consent & Signature

Complete the form by signing below and granting permission where indicated.
Photo/Video Release - I give permission for my child’s photo or video to be used in school-related materials.*

YesNo
Typed Signature (Your Full Name)
Should be Empty:

2025–2026 Student Registration Form

Section 1: Parent/Guardian Information

Section 2: Student Information

Section 3: Program Confirmation

Section 4: Basic Medical Information

Section 5: Additional Notes & How You Heard About Us

Section 6: Agreement & Payment

Section 7: Consent & Signature