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Weekend Islamic School Online Registration Form
WEEKEND ISLAMIC SCHOOL REGISTRATION
Select Level Below
*
KG (4-5 yrs)
1 (5-6y)
2 (6-7y)
3 (7-8y)
4 (8-10y)
5 (10-11y)
6 (11-12y)
7 (12y and up)
8
9
Select Day Below
*
Friday (6:00 - 9:00pm)
Saturday (10:30am – 1:30pm)
Family Information
Father’s Name*
*
Mother's Name*
*
Address*
*
City*
*
Postal Code*
*
Home Phone No.
Cell Phone No.*
*
Email*
*
Emergency Contact Name*
*
Emergency Contact Phone No.*
*
Family Doctor’s Name
Family Doctor’s Phone No.
Children Information
Select the no. of children you wish to enroll*
*
1
2
3
4
Child 1
First Name*
*
Last Name*
*
Age*
*
Gender
*
Male
Female
Care Card No.*
*
Any Health Concerns/Allergies
Child 2
First Name*
*
Last Name*
*
Age*
*
Gender
*
Male
Female
Care Card No.*
*
Any Health Concerns/Allergies
Child 3
First Name*
*
Last Name*
*
Age*
*
Gender
*
Male
Female
Care Card No.*
*
Any Health Concerns/Allergies
Child 4
First Name*
*
Last Name*
*
Age*
*
Gender
*
Male
Female
Care Card No.*
*
Any Health Concerns/Allergies
Liability Waiver
*
I hereby understand that the information collected here will be used solely for the weekend Islamic school administration purpose. I also understand that the teachers and the BCMA are not liable for any injury to my child/children during the school hours. I am fully responsible for any damage that my child/children may cause to the Masjid property or others. I am also responsible for the timely drop off and pickup from the school. I am responsible to inform school/teacher the name of the person who will drop off/pick up the child to/from the school.
I agree to the liability waiver.
Tomorrow’s Prayer Times
Prayer
Iqāmah
Fajr
3:09
Sunrise
5:21
Duhr
1:40
Asr
7:15
Maghrib
9:03
‘Ishā
10:59
Jumu’ah: 12:30 PM during PST and 1:30 PM during DST
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