Registration

Applying for? After School ProgramSunday School-Learning SalahSunday School – Fundamental Teachings of IslamQuran Reading Program Student's First Name* Student's Last Name* Student's Date of Birth* Grade: Previously enrolled in Quranic learning: YesNo School Name Languages Spoken In School EnglishFrench Spoken At Home Medical Conditions or Allergies: Parent/Guardian information: Relation to Student First Name* Last Name* Home Phone Number* Cell Number* Email* Home Address Parent/Guardian #2: Relation to Student First Name* Last Name* Home Phone Number* Cell Number* Email* Home Address Guardian: Relation to Student Parent 1Parent 2BothOther Other: Relation to Student Name Phone Number* Email* Emergency Contact: First Name* Last Name* Relation to Student Phone Number* Cell Number* Email* I have read and agree with all the terms and conditions Parent/Guardian Sign (#1)Parent/Guardian Sign (#2)Other