Fall 2025 Registration
This form is an electronic registration form for the Fall 2025 semester.
Sign in to Google to save your progress. Learn more
Email *
Student is a *
Day of Attendance *
Student Name (FIRST AND LAST) *
Student Date of Birth *
MM
/
DD
/
YYYY
Please list any allergies *
Mother's Name *
Mother's Phone Number *
Mother's E-mail *
Father's Name *
Father's Phone Number *
Father's E-mail *
Emergency Contact Name and Phone Number *
Previous Teacher *
Payment Method

REGULAR  REGISTRATION  PRICES:
-$450 FOR EACH CHILD

Completion of this form is not a form of payment- Payment will be made via Zelle (with students names) or in the office.
*

The undersigned hereby acknowledges that participation in attending Masjid El Farouq and its sponsored activities involves inherent risk of physical injury and assumes all such risks. The undersigned hereby agrees that for the sole consideration of El Farouq allowing the undersigned to participate in any the activity for which or in connection with which Masjid El Farouq and El Farouq Weekend School has made available any equipment, facilities, grounds or personnel for such programs or activities, the undersigned does hereby release and forever discharge  El Farouq Weekend School and Masjid El Farouq Board, Volunteers  and its members individually, and its officers, agents and employees of any and all claims, demands, rights and causes of action of whatever kind of nature, arising from and by reason of any and all known and unknown, foreseen and unforeseen bodily and personal injuries, damage to property, and the consequence thereof, resulting from participation in or in any way connected with the above named activity.

 

In an emergency, I acknowledge that I am solely responsible for all medical and other costs arising out of bodily injury or any loss sustained through participation in this activity. I authorize El Farouq program staff to secure any licensed hospital, physician and/or medical personnel any treatment deemed necessary for the participant’s immediate care.

 

By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages, and losses of any type, which may occur to me, and I hereby fully and forever release and discharge El Farouq, its officers, employees, and insurers including any self‐insurance funds of Masjid E Farouq from any and all claims, demands, damages, rights of action, present and future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of my participation in this activity. I have read the above carefully before signing. Further, I understand that this release and waiver of liability shall be effective for the period that my child is currently in attendance at Masjid El Farouq Weekend School.

Refund Policy

·         Refund Policy applies to all types of applications

·         100% refund will be paid only at least two weeks before the School starts.

·         50% refund will be paid only one week before the School starts.

·         No refunds are possible on/after the first day of School

By typing your FIRST AND LAST NAME you consent to the electronic signature of these terms.

*
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Masjid El Farouq.

Does this form look suspicious? Report