Participant information *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please indicate which summer camp(s) you would like to register for *

Sayyida Khadija | 11-14y/o | Aug 4 - 7

Sayyida Khadija | 7-10y/o | Aug 11 - 14

Sayyida Aisha | 11-14y/o | Aug 18 - 21

Sayyida Aisha | 7-10y/o | Aug 25 - 28

Parent/Guardian Information *

First Name

Last Name

Phone *

(###)

###

####

Emergency Contact (other than parent/guardian) *

First Name

Last Name

Phone *

(###)

###

####

Does your child have any allergies, medical conditions, or special needs we should be aware of? *

Yes

No

Permissions

I give permission for my child to participate in all camp activities

I give permission for my child to be photographed for camp memories and internal use

I give permission for my child to be photographed for social media and promotion purposes

I understand my child must follow camp rules and Islamic guidelines

Payment & Confirmation Policy *

To secure your child’s place, a 50% deposit ($60 USD/$80 CAD) must be paid in cash at time of registration. The deposit should be dropped off to the camp location. Full payment is due in cash on the first day of camp. Spots are limited and will be confirmed only after the deposit is received.

I understand