Quran Class Registration

Section 1: STUDENT'S PERSONAL DETAILS
First Name:
Last Name:
Date of Birth:
Address:
Names of any brother(s)/sister(s) already attending the school:
1:
2:
 
Section 2: PRESENT KNOWLEDGE
Name(s) of Islamic School(s) attended in the past and dates of attendance:
Name of School (Any City/Country):
From:
To:
Name of School (Any City/Country):
From:
To:
Please provide level of current knowledge about following:
Quran Reading Knowledge:
Islam/Fiqh Knowledge:
Prophet Muhammad (S.A.W.W):
 
Section 3: HEALTH CONCERNS
Please provide information if any health problem requiring special attention:
 
Section 4: PARENT/GUARDIAN INFORMATION
Father's Name:
Father's Email:
Father's Office Telephone:
Father's Cell Phone Telephone:
Mother's Name:
Mother's Email:
Mother's Office Telephone:
Mother's Cell Phone Telephone:
 
Section 5: DECLARATION
I confirm that, to the best of my knowledge, the information provided in this form is correct. I have understood and agree to abide by all rules including discipline and tuition fee payment and refunds. I also acknowledge that while the NAIF does its best to ensure the safety of each participant’s life, health and property, NAIF cannot be held responsible for any damage to these.
 
CONSENT FOR EMERGENCY MEDICAL TREATMENT
I HEREBY GIVE CONSENT TO NAIF AND ITS AFFILIATES TO PROVIDE ALL EMERGENCY MEDICAL OR DENTAL CARE TREATMENT NECESSARY TO PRESERVE THE LIFE, LIMB OR WELL BEING OF THE APPLICANT NAMED ABOVE INCLUDING BUT NOT LIMITED TO CALLING 911.
 
PHOTO RELEASE
I, give permission to NAIF AND ITS AFFILIATES to publish photos/images/videos of me or my child on web site, and other social media and advertising material, including but not limited to: Facebook, Twitter, Instagram, Pinterest, YouTube, flyers, catalogs, brochures, and other advertising media. In granting this permission, I understand that NAIF may use them for purposes such as celebrating achievements and publicizing NAIF events. I am signing this release form with the knowledge that any photos/images/videos posted on the NAIF Web site and other social media and advertising material, as outlined above, can be downloaded and reprinted by various news organizations, including print, electronic and broadcast media, and I, therefore, release NAIF from any liability arising from use of my or my child’s photos/images/videos in postings. Additionally, I understand that there are potential dangers associated with the posting of personally identifiable information on a Web site. I further understand that if I wish to rescind this agreement, I may do so at any time by sending a request to NAIF in writing. The requested rescission will take effect upon NAIF’s receipt of the signed letter and will be applied for future incidents ONLY.
 
Section 6: SCHEDULE AND FEE STRUCTURE
Admission Fee (non-refundable):$25
Books (Complete Set) and Material Fee (non-refundable):$40
 
Please select the days to enroll:
ThursdayFridaySaturdaySunday
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