Dar-ul Huda Sunday School Student Registration Form 2018 - 2019
This form is to register your child(ren) for Session 1 of the 2019 - 2020 Sunday School year. Session 1 will run from 11:00 AM - 1:30.

Due to limited space in Sunday School, filling out this form does NOT guarantee your child a space. We will contact you to confirm your child's registration Insha'Allah.
Email address *
Student Information
Student First Name *
Your answer
Student Last Name: *
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's age on September 2, 2019 *
Child must be at least 5 years old on September 2, 2019. Proof of age will be required at in-person registration.
Your answer
Student's grade in school: *
Gender *
What languages does student speak well?
Your answer
Student's Email Address
If student has his or her own email address, please provide it. Do not put the parents' email address here. You will have the opportunity later in this form to provide email addresses for parents and guardians.
Your answer
Parent or Legal Guardian Information
Parent 1/Guardian Full Name: *
Your answer
Relationship to Student: *
(Father, Mother, Legal Gardian, ect.)
Your answer
Parent's Email Address: *
Please do not give child's email address
Your answer
Parent's Phone Number: *
Your answer
Home Address: *
Your answer
Parent 2 or Legal Guardian Information (Optional)
Parent/Guardian 2 Full Name:
Your answer
Relationship to Student:
(Father, Mother, Legal Gardian, ect.)
Your answer
Home Address:
Your answer
Phone Number:
Your answer
Parent 2 Email Address:
Please do not give child's email address
Your answer
Emergency Contact
This person will be contacted in the event that a Parent or Legal Guardian cannot be reached.
Emergency Contact's Full Name *
Your answer
Emergency Contact's Phone Number: *
Your answer
Emergency Contact's Relationship to Student *
(Relative, Friend of Family, ect.)
Your answer
Student Medical Information
Does the student have any medical conditions? Please indicate whether your child needs extra assistance of any kind. *
Write "none" if not applicable
Your answer
Allergies: *
Food, medicine, ect. (write "none" if not applicable)
Your answer
Child's Physician:
Your answer
Physician's Phone Number:
Your answer
Health Insurance Provider:
Your answer
Health Insurance Policy Number
Your answer
In the case of an emergency involving my child and I cannot be reached, I authorize the school administration to seek and authorize the examination and medical treatment of my child by the appropriate medical professionals and facility. I understand that the staff of Dar ul Huda of Charlottesville is not liable or responsible for my child’s medical condition or treatment. My child may participate in activity sessions provided and supervised by the school administration. *
Please write your name below to sign.
Your answer
Tuition
Tuition cost for Dar-ul Huda Sunday School is $150 for the first child, $145 for the second child, and $130 for the third child and after.
Dar-ul Huda accepts all children regardless of their financial situation. If your child receives financial aid at public school (such as free/reduced lunch fess, ect.), he or she qualifies for free or reduced tuition at Dar-ul Huda. Please bring proof of your child's financial aid from his or her public school on registration day, and we will discuss financial aid options. *
Does your child require financial aid?
Parent Volunteering
Some of our best teachers have been the parents. This is not a coincidence because the parent has a natural ability to teach their own children and can use that skill for the betterment of the whole community. Are you willing to teach/volunteer for the Sunday school? *
Questions regarding student's Islamic knowledge
Number of Surahs student has memorized: *
What is the highest surah in Juz Amma that your child has memorized? *
Is the student fluent in reading Arabic text in the Quran? *
Does the student know how to perform the obligatory salat (prayer) on his or her own? *
Transportation
While the Sunday school does not provide or guarantee transportation, we may be able to get you in touch with other parents who are willing to carpool.
Do you need assistance with transportation to Sunday school?
Are you willing to help drive others to Sunday school?
Who is authorized to pick up your children from Sunday School?
Aside from the parents, legal guardians, and emergency contacts listed above, please list any additional persons that are allowed to pick-up or checkout your child from Sunday school. (Please provide full names and separate each name with a comma. You may add to this list later by emailing us at darulhudacharlottesville@gmail.com) *
Your answer
In order to complete your child's registration, you MUST attend one of the two on-site registrations at ISCV. Please choose the registration date below that you will attend. Please note that if you do NOT attend one of the two registration sessions below, your child's registration is NOT complete. *
Required
A copy of your responses will be emailed to the address you provided.
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