IQRA Summer Camp Registration Form 2017

Tution: $125 per week for 1st child, $100 per week for 2nd, $85 per week for 3rd, $50 per week for 4th and 5th child is FREE.

Tuition fee does NOT cover field trip fees. Field trips are priced separately.

IQRA Summer Camp will be held during July 10 and July 28 from 9:00 a.m - 3:00 p.m.

The schedule is as follows:

  • Week 1: July 10 - July 14
  • Week 2: July 17 - July 21
  • Week 3: July 24 - July 28
  • Field Trip every Wednesday

NOTE: PayPal adds 3% service charges, if you choose to pay with PayPal, 3% of the amount due would be added to the total (it would show up as Tax but it's service charges).

(*) indicates that this field is mandatory.

Participant Information
First Name (*)

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Date of Birth (*)

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Add one more child? (+$100 per week)   
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Add one more child? (+$85 per week)   
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Date of Birth (*)

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Age (*)

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Gender (*)

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Add one more child? (+$50 per week)   
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Date of Birth (*)

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Age (*)

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Grade (*)

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Gender (*)

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Add one more child? (FREE)   
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Additional Information
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Ethnicity:
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Allergies / Special Medical Concerns
Child #1

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Child #2

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Child #3

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Child #4

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Child #5

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Parent Information
Mother: First Name (*)

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Phone Number (*)

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Email (*)

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Father: First Name (*)

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Weeks of Attendance
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Please select at least 1 week

 

Payment Information
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