Summer Camp Registration Form

The Perfect Camp for Kids (and Parents!) Who Want It All , Without the Full Summer Commitment

Our 2-week Shams Stars Summer Camp is the perfect balance of faith, fun, and flexibility! Whether you're planning a vacation later in the summer or simply want your child to enjoy an uplifting break filled with creativity, character-building, and connection this is the camp for you.In just two weeks, your child will dive into inspiring Islamic learning, life skills, hands-on projects, outdoor fun, field trips and more all while making new friends and lasting memories. Spots are limited -reserve your child’s place today!
Camper's Name

First NameLast Name
Camper's Birth Date

MonthDayYear
Current School Name
Gender
Does your child have any allergies?
Tell us about your child’s Qur’an progress so far (reading & memorization)
Any Dietary Restrictions ?
Would you like to register another child?
Camper's Name

First NameLast Name
Camper's Birth Date

MonthDayYear
Current School Name
Gender
Does your child have any allergies?
Tell us about your child’s Qur’an progress so far (reading & memorization)
Any Dietary Restrictions ?
Parent/Guardian Information
Mother's Name

First NameLast Name
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Father's Name

First NameLast Name
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Interested in being a chaperone for our field trips? Note: All chaperones must be 18+ and available on [Thursday,June 5th & Friday,June 13th ]
Help us get to know your child better! Feel free to share any special instructions, preferences, or information that will help us support your child.
Interested in a Social Media Internship? We are looking for enthusiastic individuals to help manage our camp's social media presence. If you're interested or know someone who might be, please contact us at (224) 836-1086. Interns will enjoy exclusive perks!
How did you hear about our Summer Camp?
If someone referred you, please provide their name: (We’d love to know so we can thank them!)
Please review our Parent Handbook
Parent Handbook Agreement

CAMP FEE

REGISTRATION

$200.00 Quantity

Week 1

June 2- June 6

$100.00 Quantity

Week 2

June 9- June 13

$100.00 Quantity

FIELD TRIP

$25.00 Quantity

BEFORE CARE ONLY

8am - 10am

$90.00 Quantity

AFTER CARE ONLY

2pm - 5pm

$110.00 Quantity

BEFORE & AFTER CARE

8am-10am & 2pm-5pm

$200.00 Quantity

Enter coupon

Total

Payment Instructions

Please send the total amount to :

Name: Shazia Hadi
Zelle: (224) 410-5253
Memo : Include your child’s full name in the payment memo.
Upload Payment Screenshot

Cancelof
Should be Empty:

The Perfect Camp for Kids (and Parents!) Who Want It All , Without the Full Summer Commitment

CAMP FEE