Kalimah Programs' Registration Form

If you experience technical issues, click "Save" at the bottom and the form will send you an email with saved entries. Complete and submit from a different device/browser after checking all fields for accuracy and completion.

To know more and see snippets of our programs from previous years, visit https://bit.ly/KalimahRocks and https://www.kalimahprograms.org/

Program(s) of choice:

Participant's Name*

First NameLast Name

Participant's Date of Birth*

Participant's Gender*

FemaleMale

Parent/Guardian's Name (if participant is a minor)

First NameLast Name

Email*

Confirmation Emailexample@example.com

Phone Number*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Allergies, Special Needs, and/or Accommodation Requests

Registration is complete and a spot is guaranteed upon program fee payment. In the case a program is full but registration still goes through, the program administrators will contact you for options.

Fees are fully refundable if registration cancellation is requested in writing at least one week before a program's start date. If cancellation is requested less than a week before the program starts, a $50 processing fee plus any incurred costs of materials will be deducted and the remaining amount of the fee may then be refunded. If cancellation is requested after the program has already started, a prorated fee for the remaining number of classes may be refunded after a $50 processing fee and incurred costs are deducted. Please allow 5-10 days after the written request for refunds to be processed.

For alternative payment methods or to set up a payment plan, contact us at info@KalimahPrograms.org

Summer camp info: https://kalimahprograms.org/steam-summer-camps

Signature*

I GIVE MY CHILD PERMISSION TO PARTICIPATE IN ALL KALIMAH ACITIVITES. I RELEASE, HOLD HARMLESS, AND INDEMNIFY KALIMAH AND ALL OF ITS STAFF, VOLUNTEERS, AND AFFILIATES FROM AND FOR ANY CLAIM, INJURY, OR OTHER LIABILITY OF ANY KIND WHICH IS CAUSED DIRECTLY BY PARTICIPANT, OR WHICH RESULTS FROM OR DURING MY CHILD'S PARTICIPATION IN THE PROGRAM. ON BEHALF OF THE CHILD/PARTICIPANT, I HEREBY CONSENT TO THE USE OF PHOTOGRAPHS, VIDEO FOOTAGE, AND CLASSWORK OF THE PARTICIPANT IN PUBLICATIONS, WEBSITE, AND OTHER MEDIA RELATED TO KALIMAH PROGRAMS.

Total

USDAmount total for programs of choice above (Zelle option is preferable if possible: Zelle to (301) 956-3269 and note "Kalimah Spring 2025" and participant's name in Zelle along with submission of this form)

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Kalimah Arabic Programs