American Imams Academy
Programs
Programs Sign-up
Kindly fill out the form below to sign-up for our programs. If interested in multiple programs, fill out the form once for each person. All the information *required* is important to ensure we are able to reach you if needed. Jazakum Allahu Khairan
Student Name
*
First Name
Middle Name
Last Name
Student Age
*
Parent/Guardian 1
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Parent/Guardian 2
First Name
Last Name
E-mail
example@example.com
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best way to reach you
*
Phone Call
Text
Email
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Emergency Contact
In case of an emergency, who should we contact? (Please list someone you trust and notify them)
Emergency Contact 1
*
First Name
Last Name
Relationship to Child
*
Phone Number
*
Please enter a valid phone number.
Emergency Contact 2
First Name
Last Name
Relationship to Child
Phone Number
Please enter a valid phone number.
Anyone else you'd like to add to the emergency contacts?
List any and all allergies or medical conditions we should be aware of:
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Waiver
I/We the parent(s) hereby give my/our approval to for my/our child to participate in any/all activities during the school year. I/We will notify the teacher/staff of American Imams Academy should I/We chose for my/our child to avoid specific activities for any reason. I/We assume all risks and hazards incidental to such participation with American Imams Academy, including, but not limited to, transportation to and from the center, field trips and activities, accidents, injury or death while at American Imams Academy or while my/our child is in the care of teachers/staff of American Imams Academy. I/We do herby waive, absolve, indemnify and agree to hold harmless American Imams Academy and their staff and guest participants and persons teaching my/our child. I/We agree in the event of an emergency that requires immediate action before I/We can be reached for a staff member of American Imams Academy to use their best judgement in the treatment/care of my/our child, including but not limited to, CPR, bandaging, taking your child to the emergency room and administering medication to treat severe acute conditions such as allergic reaction, injuries, etc...
Signature
*
I hereby give you the permission to share my child/children's photos and videos taken during the program.
*
I agree
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Programs
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Sunday School
Weekly on Sundays Timings: 9:30am - 2:00pm Ages 5-14 years old August 20, 2023 - May 26, 2024 $75/mo per child $30 for books (one-time charge included in first month's payment)
$
105.00
for the
first month
then,
$
75.00
for each
month
Reading & Tajweed
2 Hours starting with reading then Tajweed 2 Days a week 4:00 - 6:00PM or 6:00 - 8:00PM Monday - Thursday $65/person
$
65.00
for each
month
Full-time Hifdh Program (4 hours x 4 days)
4 Hours of hifdh, reading and recitation 4 Days a week 4:00 - 8:00PM Monday - Thursday $230/person
$
230.00
for each
month
Part-time Hifdh Program (2 hours x 4 days a week)
2 Hours of hifdh, reading and recitation 4 Days a week OR 4 Hours, 2 days a week 4:00 - 6:00PM or 6:00 - 8:00PM Monday - Thursday $115/person
$
115.00
for each
month
Annual Sunday School Payment (full payment)
Discounted payment if you pay program in full. Full price is $780, discounted price is $730
$
730.00
for each
year
Email
Payment Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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