Summer Camp Registration Form 2026

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.

Summer Camp will be held during July 6 and July 24, timings are 9:00am - 3:00pm.

The schedule is as follows:

  • Week 1: July 6 - July 10
  • Week 2: July 13 - July 17
  • Week 3: July 20 - July 24

(*) indicates that this field is mandatory.

Participant Information
First Name (*)

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Last Name (*)

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

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Last Name (*)

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

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Last Name (*)

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

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Last Name (*)

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

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Last Name (*)

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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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Additional Information
Address

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City

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State

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Zipcode

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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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Last Name (*)

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Phone Number (*)

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Email (*)

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Father: First Name (*)

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Last Name (*)

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Phone Number (*)

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Email (*)

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Are you willing to assist with the Field Trips?
Are you willing to assist with the Field Trips?

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Weeks of Attendance
Please select 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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