Daar Ibn Umar: Afternoon Maktab

Times:
Tuesday 5:00pm - 7:00pm
Wednesday 5:00pm - 7:00pm
Thursday 5:00pm - 7:00pm
Friday (Boys Only) 5:00pm - 7:00pm

Seperate Boys and Girls Classes

Please verify that you are human*

Student Information:

Student Name*

First NameLast Name

Date of Birth*

Date

Gender*

MaleFemale

Current School Grade*

Language Spoken at Home

Extent of Previous Islamic Education:

(Beginner, Qa'idah, Can Recite Qur'an, Surahs Memorised, Etc.)

Any Medical Conditions We Should Be Aware Of:

(Allergies/Illness/Medication/Etc.)

Parent/Guardian Information:

Please Specify Your Relationship with the Applicant*

Please choose one

Father/Guardian 1*

First NameLast Name

Mother/Guardian 2*

First NameLast Name

Primary Contact No*

Secondary Contact No

Email*

example@example.com

Address*

Street Address

Street Address Line 2

SuburbState

Post Code

Emergency Contact Details: (other than above individuals)

Emergency Contact*

First NameLast Name

Emergency Phone No*

Relationship to student*

I understand and affirm that the information on this form is complete and accurate. The faculty will ensure a safe and secure learning environment is created in the interest of the students. Therefore, as a parent/guardian of the student registered above, I release MCSC/ Daar Ibn Umar from liability in the event of personal injury or accident caused to the student while he/she is at the Minto Community Study Centre Inc. / Daar Ibn Umar premises or after teaching hours. Students will not be permitted to leave early or arrive late without a written and signed note from their parent/guardian.

I agree to see that my enrolled child is punctually brought and picked up on time. A 5-minute “Grace” period will be tolerated for any late comers.

The student’s continued acceptance in the program will be based upon his/her conduct and attendance. The Maktab/Madrasah administration reserves the right to withdraw the student from the program if the previous qualities are found unsatisfactory.

*Registration Fees (Non-refundable): Cover enrolment and initial books needed.

* Tuition fees (Non-refundable): A nominal tuition fee of $225 per student per term, annually ($900). $390 per term for two students, annually ($1560). And $450 per term for three or more students, annually ($1800).

Fees must be paid in full at the beginning of each Term. If for some reason, the full fee cannot be paid as per the below mentioned two methods, please contact the administration.

*Note: Completion of this form does not guarantee a spot in the class. We will contact you to confirm you enrolment.

Fees to be Paid*

Please select one of the above

Agreement and Waiver and Release

I hereby declare that I am the Legal Guardian of the above child/applicant. I hereby additionally consent to my child or ward, upon his/her admission to Minto Community Study Centre Inc./Daar Ibn Umar, for participation in all Minto Community Study Centre/Daar Ibn Umar activities. And hereby execute this AGREEMENT, WAIVER AND RELEASE on the Applicant's behalf and discharge any and all claims for damages for personal injury, death, or property damage, mental or emotional harm of any kind which he/she/they may have or may hereafter accrue to the Applicant as a result of participation in said activities, except as non-waivable by law. This release is intended to and shall discharge in advance Minto Community Study Centre Inc./Daar Ibn Umar (its officers, employees, volunteers and agents) free and harmless for any loss, liability, cost or expense incurred as a result of his/her death, injury or property damage that the Applicant may sustain while on any premises being used by Minto Community Study Centre Inc./Daar Ibn Umar while participating in programs and activities.

I HAVE CAREFULLY READ THIS AGREEMENT AND WAIVER, AND RELEASE AND FULLY
UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A LEGALLY BINDING AGREEMENT
AND A RELEASE OF LIABILITY, A LEGALLY BINDING CONTRACT BETWEEN MINTO COMMUNITY STUDY CENTRE INC./DAAR IBN UMAR AND ME AND THE APPLICANT. I AGREE TO IT OF MY FREE WILL.
ANY UNENFORCEABLE PROVISION IN THIS AGREEMENT SHALL BE SEVERABLE AND SHALL NOT AFFECT THE ENFORCEABILITY OF ALL OF THE AGREEMENT’S OTHER PROVISIONS.

I have Read, Understood and Agreed to all of the above*

Yes

In addition, I have read, understood and intend to abide by the Policies and Procedures of the MCSC/Daar Ibn Umar.*

I Agree

*Note: This application does not confirm a place for the applicant. Upon successful admission we will contact you via Email, Text or Letter to inform you when the applicant may start attending classes.