Clone of Tafheem Program

American Imams Academy

Programs
Programs Sign-up

Kindly fill out the form below to sign-up for our programs. If interested in multiple programs, fill out the form once for each person. All the information *required* is important to ensure we are able to reach you if needed. Jazakum Allahu Khairan
Student Name

First NameMiddle NameLast Name
Student Age
Parent/Guardian 1

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 2

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Best way to reach you

Emergency Contact

In case of an emergency, who should we contact? (Please list someone you trust and notify them)
Emergency Contact 1

First NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2

First NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Anyone else you'd like to add to the emergency contacts?
List any and all allergies or medical conditions we should be aware of:

Waiver

I/We the parent(s) hereby give my/our approval to for my/our child to participate in any/all activities during the school year. I/We will notify the teacher/staff of American Imams Academy should I/We chose for my/our child to avoid specific activities for any reason. I/We assume all risks and hazards incidental to such participation with American Imams Academy, including, but not limited to, transportation to and from the center, field trips and activities, accidents, injury or death while at American Imams Academy or while my/our child is in the care of teachers/staff of American Imams Academy. I/We do herby waive, absolve, indemnify and agree to hold harmless American Imams Academy and their staff and guest participants and persons teaching my/our child. I/We agree in the event of an emergency that requires immediate action before I/We can be reached for a staff member of American Imams Academy to use their best judgement in the treatment/care of my/our child, including but not limited to, CPR, bandaging, taking your child to the emergency room and administering medication to treat severe acute conditions such as allergic reaction, injuries, etc...
Signature
I hereby give you the permission to share my child/children's photos and videos taken during the program.

Full Time Hifz

Full time hifz from 8:30 AM - 2:00 PM

$250.00 for each month

Tafheem Program

Tafheem program includes 3 hours Quran 45 min Arabic 45 min Islamic Studies x2

$250.00 for each month

Morning Part-time Hifz

Part time Hifz 8:30 AM - 11:30 AM

$150.00 for each month

Morning Part time Hifz

Part time Hifz 11:30 AM - 1:30 PM

$150.00 for each month

American Imams Academy