Registration - Boorhaanol Islam Movement

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USERNAME

PASSWORD

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ALREADY HAVE AN ACCOUNT?

Your Name:
Email:
Phone:

First Name(s): Surname:
Birthdate:

Group: Tiny TotsPreschoolers (Grade R)JuniorsAdvanced Preschoolers (Grade R+)
Home Language: EnglishAfrikaansXhosaOther
If "Other", please specify:

Potty Trained: YesNo
Vaccinated: YesNo
Vaccinated against: MeaslesChicken PoxMumpsGerman Measles
Allergies:

Name: Telephone:

Name: Telephone:

Name: Telephone:

Additional information:

021 424 1864
196 Longmarket Street
Bo-Kaap, Cape Town
8001, South Africa

021 423 7690
81 Dorp Street, Bo-Kaap
Cape Town, 8001
South Africa

021 423 7460
Pentz Street, Bo-Kaap
Cape Town, 8001
South Africa

Phone: 021 424 1864
Email: info@boorhaanol.org.za
WhatsApp: 084 222 1308

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