Muslim Kids Summer Holiday Programme SHP2020
Please fill in ONE form PER child. (For boys & girls aged between 5 years -12 years old ONLY)
Date: From Monday 20th to Friday 24th JANUARY 2020
Time: 9am-1pm
Venue: Masjid An Nur

If you have any questions, please contact us at jumayahjones@gmail.com
Email address *
Name of child *
Your answer
Gender of child *
Date of birth of child *
Children must be between 5-12 years old.
MM
/
DD
/
YYYY
Home Address *
Your answer
Phone number *
Your answer
Name of parent/s or guardians: *
Your answer
Emergency Phone contact *
Your answer
Any other relevant information we need to know about your child (e.g. allergies, medical issues etc) *
Your answer
Would you like to contribute or help during the program as a parent helper? *
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