Summer Camp Registration Form 2025

Tuition fee: $140 per week for 1st child, $125 per week for 2nd, $110 per week for 3rd, $100 per week for 4th and additional family members are FREE.

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

Before and after camp care available at $20 per day billed separately.

Summer Camp will be held during June 23 and July 11, timings are 9:00am - 3:00pm, before-care starting at 7:30am and after-care till 4:30pm.

The schedule is as follows:

  • Week 1: June 23 - June 27
  • Week 2: June 30 - July 4
  • Week 3: July 7 - July 11

(*) indicates that this field is mandatory.

Participant Information
First Name (*)

Invalid Input 		Last Name (*)

Invalid Input 		Date of Birth (*)

Invalid Input 		Age (*)

Invalid Input 		Grade (*)

Invalid Input 		Gender (*)

Invalid Input
Add one more child? (+$125 per week)   
First Name (*)

Invalid Input 		Last Name (*)

Invalid Input 		Date of Birth (*)

Invalid Input 		Age (*)

Invalid Input 		Grade (*)

Invalid Input 		Gender (*)

Invalid Input
Add one more child? (+$110 per week)   
First Name (*)

Invalid Input 		Last Name (*)

Invalid Input 		Date of Birth (*)

Invalid Input 		Age (*)

Invalid Input 		Grade (*)

Invalid Input 		Gender (*)

Invalid Input
Add one more child? (+$100 per week)   
First Name (*)

Invalid Input 		Last Name (*)

Invalid Input 		Date of Birth (*)

Invalid Input 		Age (*)

Invalid Input 		Grade (*)

Invalid Input 		Gender (*)

Invalid Input
Add one more child? (FREE)   
First Name (*)

Invalid Input 		Last Name (*)

Invalid Input 		Date of Birth (*)

Invalid Input 		Age (*)

Invalid Input 		Grade (*)

Invalid Input 		Gender (*)

Invalid Input

 

Additional Information
Address

Invalid Input 		City

Invalid Input 		State

Invalid Input 		Zipcode

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Allergies / Special Medical Concerns
Child #1

Invalid Input 		Child #2

Invalid Input
Child #3

Invalid Input 		Child #4

Invalid Input
Child #5

Invalid Input

 

Parent Information
Mother: First Name (*)

Invalid Input 		Last Name (*)

Invalid Input 		Phone Number (*)

Invalid Input 		Email (*)

Invalid Input
Father: First Name (*)

Invalid Input 		Last Name (*)

Invalid Input 		Phone Number (*)

Invalid Input 		Email (*)

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Are you willing to assist with the Field Trips?

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Weeks of Attendance
Please select weeks of attendance:

Please select at least 1 week

 

Payment Information
Total:

Please make your payment onsite via Kiosk machine in the masjid or by cash, you can pay by the week as well.

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