Madrasah Registration

Only children 6 years and up will be accepted for Madrasah classes.

First Name

Last Name

Father Name

Mother Name

Date of Birth

Grade

Gender

Address

City

Province

Postal Code

Home Phone

Cell Phone

2 + 3 = ?

Emergency Contact

Contact Name

Home Phone

Cell Phone

Relationship

I/We have read and agree with Markaz Ul Islam privacy & Term of condition.

I understand and affirm that: The responsibility of drop off/pickup are solely with the parents/guardians. Teacher/Staff/Volunteers shall not be held responsible for any accidents/actions before/ after classes. I/We have read and agree with the terms/conditions/policies for admission of our child.

Markaz-Ul-Islam

Madrasah Registration

Emergency Contact

Servives

Contact Info

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