Quran Classes Registration
Parent's Name
*
First Name
Last Name
Relationship to Child(s)
Father
Mother
Guardian (Male)
Guardian (Female)
Phone Number
*
-
Area Code
Phone Number
Whatsapp Number (If different from cell numbers)
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Configurable list
*
HEALTH SCREENING
*
I do NOT have any of these symptoms: Fever, New onset of cough, Worsening of chronic cough, Shortness of breath, Difficulty breathing, Sore throat, Difficulty swallowing, Decrease or loss of sense of taste or smell, Chills, Unexplained headaches, Unexplained fatigue, malaise, muscle aches, Nausea/vomiting, diarrhea, stomach pain, Eye pain or pink eye (conjunctivitis), Runny nose or stuffy nose without known cause
I have NOT travelled outside of Canada or had close contact with anyone that has travelled outside of Canada in the past 14 days
I have NOT travelled outside of Canada or had close contact with anyone that has travelled outside of Canada in the past 14 days
I Agree to the Following Terms
*
1. The Darul Hijra Summer Day Camp reserves the right to cancel a child’s participation in a camp session if their behavior is deemed unmanageable or dangerous to themselves or others, in which case they will be sent home immediately.
2. Although every effort is made to send campers home with all of their belongings, Darul Hijra Summer Day Camp is not responsible for any loss or damage.
3. In the event your child is injured, ill or in need of medical attention and you are unable to be contacted, you authorize Darul Hijra Summer Day Camp staff to seek medical attention on your behalf.
4. You release Darul Hijra, its staff from all manner of actions, claim and demands of whatever nature which result from any loss, injury or expense sustained, arising out of or in any way connected with participation in any program or attendance at a location operated by Darul Hijra.
5. You agree to allow my child(ren) to participate in all camp activities and in any supervised trips to places not on the camp property. You authorize Darul Hijra Summer Day Camp to use any photographs taken of your child while participating in Darul Hijra Summer Day Camp programs for future promotional materials.
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