Masjid Salahadeen Sunday School Registration Form FALL 2025
5 - 15 YEAR OLD STUDENTS ONLY
Child's Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender of Student
Male
Female
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother's First and Last Name
First Name
Last Name
Mother's Phone Number
Please enter a valid phone number.
Father's First and Last Name
First Name
Last Name
Father's Phone Number
Please enter a valid phone number.
Emergency Contact Name
First Name
Last Name
Relationship
Emergency Contact Phone Number
Please enter a valid phone number.
Any Allergies or Medical Conditions?
Yes
No
Please give details
Do you want to add something about your child?
Please upload a profile picture of the child
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I, undersigned, agree with the following statements:
*
I understand I must pick up my student(s) after Dhuhr Salah.
I understand the tuition fee is due in full by the first day of each month and I will pay it.
I acknowledge that Masjid Salahadeen is NOT responsible for any injuries or treatment acquired while on the Masjids property.
I understand my students must wear proper masjid attire to class (hijab, long pants, long dress for girls; long pants, long shirt for boys) and bring ALL books and materials provided for each class day. My students must also follow and respect ALL masjid rules including NO CELL PHONES in or during class. (If you need to speak with your child, please contact Brother Adil at (469) 544-0984 or Sister Liya at (469) 943-5926.)
I consent to photographic use of students for education and advertising purposes.
Date
-
Month
-
Day
Year
Date
Signature
Submit
Submit
Should be Empty: