Ai Course for Muslim Youth Registration Form

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Please fill out and submit this form.
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Email* This field is required.
example@example.com
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Phone Number * This field is required.
Please enter a valid phone number.
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City and State (e.g. Wylie, TX)* This field is required.
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Now Let's Add Student(s) Info
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Student #1 Full Name* This field is required.
First Name
Last Name
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Student #1 Age* This field is required.
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Student #2 Full Name
First Name
Last Name
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Student #2 Age
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I, hereby give my consent for the recording of this course. I understand that the recordings may be used for educational purposes and can be shared with participants as part of the course materials.* This field is required.
I acknowledge
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Are you paying now or later?
Paying NowLater when I am convinced
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PAYING FULL AMOUNT $150

https://link.waveapps.com/xfkr4h-2yyuz4

OR

PAYING 3 INSTALLMENTS x $60 (Total $180)
https://link.waveapps.com/vb4dg8-fpdpqb

RIJAAL Members discounted rate (Total $100)

https://link.waveapps.com/e5rr3t-6pa3y4
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Have you read all course details and agreed to everything in it? www.darutarbiya.com/videoai* This field is required.
Yes
No, I haven't read but I still agree
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