Kindergarten Application

A'Ala Yasir Educational Center — Kindergarten Program

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Kindergarten Registration

Please complete this application for a child applying to the A'Ala Yasir Kindergarten Program. The Center will review the application and contact the family regarding enrollment and placement.

Enrollment Availability Notice

Submitting an application does not guarantee immediate enrollment. If a class is full, your child may be placed on a waiting list. A'Ala Yasir Educational Center will contact you to let you know whether your child has been accepted, placed on the waiting list, or if additional information is needed.

Family Status

Are you a new family or an existing A'Ala Yasir family?*

Choose Existing A'Ala Yasir Family if you already have a child enrolled at the Center.

Family ID*

Enter your A'Ala Yasir Family ID. If you do not know it, please contact A'Ala Yasir Administration for help before submitting.

Student Information

First Name*

Middle Name

Last Name*

Date of Birth*

Gender

A'Ala Yasir Kindergarten Program

Parent / Guardian Information

Parent / Guardian 1

Full Name*

Relationship to Student

Phone Number*

Email Address

Parent / Guardian 2

Optional

Full Name

Relationship to Student

Phone Number

Email Address

Emergency Contact

Please provide someone the school can contact in an emergency if a parent or guardian cannot be reached.

Emergency Contact Full Name*

Relationship to Student*

Phone Number*

Alternate Phone Number

Email Address

Medical & Health Information

Does the student have any health conditions?*

Include any medical condition the school should know about.

Health Condition Details*

Does your child have any diagnosed or known developmental, learning, communication, behavioral, sensory, or medical support needs that require specialized services or accommodations?*

Examples may include autism spectrum disorder, significant speech or language delay, developmental delay, ADHD requiring specialized support, sensory support needs, intellectual disability, or other conditions requiring individualized assistance.

Important: A'Ala Yasir Educational Center is not a special education program and does not currently provide specialized special-needs services, one-to-one aides, therapy, or individualized clinical support. Please provide complete and accurate information so the Center can determine whether it can safely and appropriately meet the student's needs.

This application will require administrative review before enrollment can be approved.

Specialized Support / Accommodation Details*

Does the student have any allergies?*

Please include food, medication, environmental, or other allergies.

Allergy Details*

Does the student take any medications?*

Include any medication the school should know about.

Medication Details*

Kindergarten Readiness, Care & Safety Information

Doctor / Pediatrician Name

Doctor / Clinic Phone

Clinic / Medical Office

Does your child require an EpiPen?

Does your child require an inhaler?

Medication / EpiPen / Inhaler Directions

Physical Limitations or Activity Restrictions

Special Diet / Food Restrictions

Special Equipment or Assistive Items

Letter Recognition Level

Primary Language Spoken by Child

Number Recognition / Counting Notes

Learning Support Notes

Writing Readiness

Behavior / Classroom Support Notes

Communication / Speech Notes

Authorized Pickup Persons

Add every person who is allowed to pick up your child. You may add more than one person.

Additional Children

Optional. Finish the first student's information above. If you are applying for another child from the same family, click Add Another Child below. Each added child has their own class and medical information; parent and address information are shared.

Home Address

Street Address

Apt / Unit

City

State

ZIP Code

Additional Information

Previous Kindergarten / Childcare Program

Notes or Additional Information

Preferred School Communication Method*

Choose the main way you would like A'Ala Yasir Educational Center to contact you about school notices, attendance, payments, registration, and student-related information. If you checked the SMS consent box above, SMS / Text Message will be available. If you did not opt in to SMS, choose Email or Phone Call.

Preferred Method*

Parent Agreements & Authorizations

Attendance & Absence Policy

Regular attendance helps young children feel comfortable, build routines, and participate in classroom activities. If your child will be absent, please notify A'Ala Yasir Educational Center as soon as possible. If your child will be away for several days, please let the Center know the expected return date.

Vacation & Extended Absence Policy

Please notify the Center in advance when your child will be away for a vacation or other extended absence. Tuition and space-reservation rules, if applicable, will follow the Kindergarten Program’s current payment and enrollment policies.

Illness & Health Policy

Please keep your child home when they are too sick to comfortably participate in kindergarten activities or may spread illness to others. Parents or guardians should notify the Center about important symptoms, contagious illnesses, or health changes. If your child becomes ill while at the Center, we will contact you or an authorized emergency contact.

Arrival, Pickup & Authorized Persons

For your child’s safety, please follow the Kindergarten Program’s arrival and pickup procedures. A child will be released only to a parent, guardian, or person authorized by the family. Please notify the Center when an authorized pickup person changes, and identification may be requested when staff do not recognize the person.

Emergency Medical Authorization

I confirm that I have shared important health information about my child, including allergies, medications, medical conditions, and support needs. If an urgent medical situation occurs and a parent, guardian, or emergency contact cannot be reached, I authorize A'Ala Yasir Educational Center to contact emergency medical services and take reasonable steps to help keep my child safe until a parent or guardian is reached.

Photo / Video Release

From time to time, the Center may take photos or short videos during classroom activities, celebrations, or special events. Please choose below whether A'Ala Yasir Educational Center may use images of your child for school-related purposes such as newsletters, the Center website, social media, or printed materials. You may change your choice for future use by giving the Center written notice.

Photo / Video Permission*

Yes, I give permission.

No, I do not give permission.

I authorize the Center to contact emergency medical services if necessary when a parent/guardian cannot be reached.*

I give permission for my child to participate in supervised Kindergarten field trips / outings.*

Yes

Parent Certification & Agreement

I confirm that the information in this application is complete and accurate. I have read the Kindergarten policies and understand that I should keep the Center updated about changes to my child’s health, emergency contacts, authorized pickup persons, or other important information.

Parent / Guardian Full Name*

I have read and agree to the Parent Agreements & Authorizations above.*

Submitting this application does not guarantee enrollment. Applications are reviewed by A'Ala Yasir Educational Center before admission is approved.