Saturday Weekend School Registration Form

WELCOME & PROGRAM DESCRIPTION:

Welcome to DeSoto House of Peace Saturday School!

Our Saturday School provides students with an engaging Islamic learning environment combining Qur’an, Islamic Studies, Arabic, and Sports.

NEW – One Additional Hour of Sports!
We are excited to expand our sports program by adding one additional hour of organized sports and physical activities each Saturday.

Students already participate in sports as part of our Saturday School program. This new additional hour provides students with more time for sports, physical activity, teamwork, and fun, while maintaining the full instructional time for Qur’an, Islamic Studies, and Arabic.

Our Saturday School Program Includes:

Qur’an
Islamic Studies
Arabic
Sports
NEW – One Additional Hour of Sport

PROGRAM INFORMATION

Saturday School Program Information

Day: Saturday
Location: DeSoto House of Peace
Address: 531 W. Belt Line Rd., DeSoto, TX 75115

Saturday School Hours: [10:00 AM-3:00 PM]
Additional Sports Hour: [3:15 PM- 4:15 PM]

Registration Fee: [$150]

Tuition FOR Saturday School: [$175]

Tuition FOR Additional Sports Hour: [$75]

Student’s Full Name

First NameLast Name

Date of Birth

Date

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Grade Level:

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PARENT/GUARDIAN INFORMATION Parent/Guardian Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please provide an emergency contact other than the primary parent/guardian whenever possible. Emergency Contact Name

First NameLast Name

Relationship

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Medical Facility

Name of Physician/Pediatrician

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

MEDICAL & HEALTH INFORMATION
Medical & Health Information

Does your child have any allergies, medical conditions, or other health concerns that our staff should be aware of?*

Any Allergies or Medical Conditions?

Please give details

Does your child have any medical or physical restrictions that would prevent or limit participation in sports or physical activities?

Please give details

AUTHORIZED PICKUP
Authorized Pickup Information

Please list any individuals, in addition to the parent/guardian listed above, who are authorized to pick up your child.

For the safety of our students, children will only be released to a parent/guardian or an authorized individual listed on this registration form unless prior authorization is provided to DeSoto House of Peace.

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

SATURDAY SCHOOL PARTICIPATION CONSENT:

Saturday School Participation Consent

I give permission for my child to participate in the DeSoto House of Peace Saturday School program, including Qur’an, Islamic Studies, Arabic, Sports, and other scheduled school activities.

I understand that sports and physical activities are part of the Saturday School program.

I also understand that DeSoto House of Peace is adding one additional hour of sports and physical activities to the Saturday School schedule. This additional sports hour is in addition to the sports already included in the program and does not replace or reduce instructional time for Qur’an, Islamic Studies, or Arabic.

SPORTS & PHYSICAL ACTIVITY CONSENT

Sports & Physical Activity Consent

I give permission for my child to participate in sports and physical activities offered through DeSoto House of Peace Saturday School, including the additional one-hour sports period.

I understand that participation in sports and physical activities involves the normal risks associated with exercise, recreation, and physical activity.

I confirm that, to the best of my knowledge, my child is able to participate in these activities unless I have identified a medical condition, physical limitation, or restriction in this registration form.

I agree to notify DeSoto House of Peace if my child’s health or physical condition changes in a way that may affect participation.

EMERGENCY MEDICAL AUTHORIZATION
Emergency Medical Authorization

In the event of an illness, injury, or medical emergency involving my child, I authorize DeSoto House of Peace staff or authorized representatives to provide basic first aid and, when reasonably necessary, obtain emergency medical assistance.

I understand that reasonable efforts will be made to contact me or the emergency contact listed on this form as soon as possible.

If I cannot be reached and immediate medical attention is considered necessary, I authorize qualified medical professionals to provide appropriate emergency evaluation and treatment.

I understand that I am responsible for any medical expenses incurred on behalf of my child.

PHOTO & VIDEO PERMISSION
Photo & Video Permission

During Saturday School, DeSoto House of Peace may take photographs or videos of students participating in classroom activities, sports, special programs, and other Saturday School activities.

Do you give DeSoto House of Peace permission to photograph or record your child and use these photos/videos for school-related communications, the DeSoto House of Peace website, social media, flyers, and promotional materials?*

Type a question

REGISTRATION & TUITION ACKNOWLEDGMENT
Registration & Tuition Acknowledgment

I understand that submitting this form does not complete my child’s registration until all required registration information and applicable fees have been received.

I understand that tuition and registration fees are subject to the DeSoto House of Peace Saturday School payment and refund policies.

If your registration fee is non-refundable, add:

Registration fees are non-refundable.

Terms and Conditions
Informed Consent and Acknowledgment

I hereby give permission for my child to participate in the activities offered by DeSoto House of Peace Saturday School, including Qur’an, Islamic Studies, Arabic, sports, and other scheduled program activities.

I understand that sports and physical activities are part of the Saturday School program and that the program also includes one additional hour of sports and physical activities. I understand that participation in sports and physical activities involves certain inherent risks, including the possibility of injury.

By allowing my child to participate, I acknowledge and voluntarily assume the ordinary risks associated with these activities. To the extent permitted by law, I release and hold harmless DeSoto House of Peace, its officers, employees, teachers, coaches, volunteers, agents, and representatives from claims or liability arising from my child’s participation in Saturday School activities, including sports and physical activities, except to the extent liability cannot legally be waived.

I understand that this acknowledgment applies to my child’s participation in activities conducted as part of the DeSoto House of Peace Saturday School program.

Medical Release and Emergency Authorization
As the parent or legal guardian of the student named in this registration form, I authorize DeSoto House of Peace Saturday School and its authorized staff to provide basic first aid to my child in the event of an illness, injury, or medical emergency.

If my child requires medical attention beyond basic first aid, I authorize DeSoto House of Peace to contact emergency medical services and, when necessary, arrange for my child to be transported to an appropriate medical facility.

I understand that reasonable efforts will be made to contact me and/or the emergency contact listed on this form as soon as possible. If I cannot be reached and my child requires immediate medical attention, I authorize DeSoto House of Peace and its authorized representatives, to the extent permitted by law, to consent to necessary emergency medical treatment on my behalf.

I authorize qualified and licensed medical professionals to evaluate and provide treatment that they determine is reasonably necessary under the circumstances of the medical emergency.

I understand that I am responsible for any medical, ambulance, hospital, or other healthcare expenses incurred on behalf of my child.

I confirm that the medical and emergency information provided on this registration form is accurate and complete to the best of my knowledge. I agree to notify DeSoto House of Peace of any significant changes to my child’s medical information.

This authorization will remain in effect for the duration of my child’s enrollment in the DeSoto House of Peace Saturday School program unless I revoke it in writing.

I, undersigned, agree with the following statements:

Please upload a profile picture of the child

We look forward to welcoming your family to DeSoto House of Peace Saturday School!

Qur’an • Islamic Studies • Arabic • Sports

Name

First NameLast Name

Date

Signature