Weekend Boys and Girls Classes
Student Registration Form
Select Class
*
Please Select
Boys Tajweed - $100.00 Per month one child, 150.00 for two
Girls Nurturing Class - $100.00 Per month one child, 150.00 for two
Student 1 Information
*
First Name
Middle Name
Last Name
Birth Date Student 1
*
-
Month
-
Day
Year
Date
Student 2 Information
First Name
Last Name
Birth Date Student 2
-
Month
-
Day
Year
Date
Student 3 Information
First Name
Last Name
Birth Date Student 3
-
Month
-
Day
Year
Date
Parent / Guardian Information
Parent/Guardian 1
*
First Name
Last Name
Parent/Guardian 1 Email
*
example@example.com
Relationship
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Phone Number
*
Please enter a valid phone number.
Number to be added to WhatsApp group for class communication
*
Please enter a valid phone number.
Parent/Guardian 2
First Name
Last Name
Parent/Guardian 2 Email
example@example.com
Relationship
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Phone Number
Please enter a valid phone number.
Emergency Contact Information
Please enter 2 emergency contacts
Emergency Contact 1
*
First Name
Last Name
Relationship
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact 1 Phone #
*
Please enter a valid phone number.
Emergency Contact 2
*
First Name
Last Name
Relationship
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact 2 Phone #
*
Please enter a valid phone number.
All information I have provided in the Islamic Foundation of Southwest Suburbs - Plainfield Registration Form is True and Correct to the best of my knowledge.
I will be responsible for any damage caused to IFSWS property by my child, and will compensate or replace the damage with equal value and quality.
I agree to follow and respect the rules and regulations and explain them to my child who will attend IFSWS classes. I understand that I am responsible for disciplining my child in case of violation of any IFSWS rules, in conduct and/or academics. I understand that if any problem occurs, I will completely and fully accept the decision of IFSWS administration.
I give IFSWS administrative the authority to take necessary decisions to ensure my children(s) safety and wellbeing when in their charge. I give my child permission to participate in all activities deemed appropriate by IFSWS.
I understand that my child will be taken on field trips with my consent.
I understand that the school will take necessary action during an emergency situation.
I am indemnifying IFSWS from any legal liability whatsoever.
Parent/Guardian Signature
*
Print
Save
Click to Complete
Click to Complete
Clear All Answers
Should be Empty: