MIA Al Noor Summer Islamic Day Camp Program

2445 Waverley Street

July 2, 2013 - August 30, 2013

Application Deadline: Tuesday, June 25, 2013

Family (Last) Name:______

Father Name: ______Mother Name:______

Home Address:______Postal Code:______

Email (Print):______

Phone: (Home)______(Work)______(Cell)______

Emergency Contact Name & Phone:______

Names of Students / Age / M/F / Medical Number
1 / Half day camp
Full day camp
2 / Half day camp
Full day camp
3 / Half day camp
Full day camp
4 / Half day camp
Full day camp
Half Day Camp Fees (10:00 AM – 2:00 PM)
Note: these fees are for 2 month.
1st Child - $150, 2nd Child - $100
3rd Child -$75, 4th Child - $75
Amount Due:______
Amount Paid:______Cash Cheque
Date of Payment:______ / Full Day Camp fees (8 AM – 5:00 PM)
Note: these fees are for 2 month.
Each Child - $600
Amount Due:______
Amount Paid:______Cash Cheque
Date of Payment:______

MIA Al Noor Summer Islamic Day Camp Program

2445 Waverley Street

July 2, 2013 - August 30, 2013

Parents’ commitment: Islamic education is a duty of parents, consequently we make following commitments to Allah SWT:

·  We will ensure that our children arrive at school on time and are picked up on time. Late pickup will result in additional $10 per every 10 minute.

·  Please ensure children bring lunch/snacks, books, note books and pens/pencils.

·  We will make sure that our children are not absent except in case of an emergency.

·  In case of emergency where our child requires medical care, permission is granted for our child to be taken to the hospital by school staff to receive that care.

Programs: The scope of study includes the reading of Qur'aan, the proper performance of Salaah, memorization of suraahs, the Tafseer of the Qur'aan, Seerah of Prophet Muhammad(PBUH) and Islamic Studies (based on the age and understanding of the child).

We need minimum 80 registrations to properly deliver this program.

MIA Summer Program Administration Team:

Br. Sadeq Shudefat: 204-899-3485

Sr. Yasmin Ali: 204-489-3803

Sr. Shahina Awan: 204-261-6235

Br. Abdul Aziz: 204-794-4695

Father/Mother/Guardian: ______

Signature:______