Hamzah Islamic Center - Sunday School Registration Form 2025-2026

School Timings: Every Sunday from 10AM to 2PM
Fees: $80* per month
One-time fees for Books: $50*

Discounts: Returning Student - 10% per month; Sibling: 10% per month; Referral: $25 (one-time)

*Financial Aid available

Student's Name*

First NameLast Name

Student's Grade*

Student's Age*

Student's Gender*

BoyGirl

Student's Date of Birth*

Date

Parent's Name*

First NameLast Name

Parent's Phone*

Parent's Email Address*

example@example.com

Emergency Contact Person Name*

Emergency Contact Person Phone No*

Students Knowledge of Qaida Noorania*

Beginner (Read Alphabets)Intermediate (Reads Arabic Words)Advanced (Can Read Quran Fluently)

Surah Memorization*

Memorized (0-5 Surah's)Memorized (5 - 12 Surah's)

Does the student have any food allergy, chronic illness or medical conditions? If yes, please describe.*

Is the student prescribed any Inhaler? If yes, please explain any instructions.*

MEDIA RELEASE:I hereby consent to the use of my child’s name, likeness, and speech in any audiotape, videotape, film, or photograph taken in any Hamzah Sunday School activity for the business or publicity purposes of Hamzah Islamic center Sunday School. I understand that any participation offers no remuneration and that my child’s name, likeness, and speech may be edited, produced, and recorded for duplication and distribution throughout the United States and abroad. I hereby release Hamzah Islamic center its licensees, assignees, affiliates and successors from any privacy, defamation, or other claims have arising out of broadcast, exhibition, publication, or promotion of this program. Please Select Yes/No*

YesNo

LIABILITY RELEASE: In the event I cannot be reached, I give permission for my child named above to be transported to a hospital and authorize the hospital to provide emergency medical and surgical treatment. I assume full responsibility for all charges related to the above, and release the hospital, Hamzah Islamic center, its Board of Directors, committee members, employees, volunteers and contractors from any and all liability, claims and causes of action arising in connection with the transportation and/or treatment of the child named herein. I agree to waive all claims against Hamzah Islamic center, its Board of Directors, committee members, employees, volunteers and contractors against injury, accident, illness or death occurring during or by reason of any field trip or excursion conducted by the school. Please Select Yes/No:*

YesNo