Boys Summer Overnight Camp 2017 Registration Form | IQRA Academy - IAC

Assalamu Alaikum Dear Brothers and Sisters,

IQRA Academy of the Islamic Association of Cary (Cary Masjid) is pleased to inform you that Registration is now Open for the Boys Summer Overnight Camp 2017! Registration deadline is August 6th, and Spots are very Limited! We do not recommend waiting to register your children until the deadline is very close because it is very likely that all spots will be filled by then.

Late Registration is August 7th until End of August 9th. Late Fee is $20 per child if payment is not submitted by end of day on August 6th. No campers will be registered after August 9th.

Boys Summer Overnight Camp 2017 is scheduled for Thursday, August 10th, 2017 until Sunday, August 13th, 2017 at William Umstead Park's Camp Lapihio Group Campsite:

Late Check-in is Friday, August 11th for Students in year-round schools.

**Please, keep in mind that Park Gates open at 7:00 AM sharp, and close at 9:00 PM sharp**

Registration is open for Boys 8-14 years old. We have a very busy camp schedule that guarantees our campers will have a unique, educational, fun, and memorable camping experience this summer. Spots won't be reserved for any camper until both registration form and payment are completed. Only Cash or Check is Accepted for Fee Payments (Checks must be made to the "Islamic Association of Cary").


Campers: Boys 8-14 years old


A. $85 for IQRA Summer Program Students Only

B. $95 for non-students of IQRA Summer Program

C. Additional $20 Late Fee if paying after End of Day on Sunday, August 6th, and by end of Wednesday August 9th.

*** Spots are not reserved until BOTH registration form and cash/check payment are received.***

Check-In: Thursday, August 10th, 5:00 PM at Camp Lapihio — William Umstead Park

Late Check-in: Friday, August 11th, after school at Camp Lapihio same address above.

Check-Out: Sunday, August 13th, 11:30 AM - 12:00 PM Same Location (Camp Lapihio at William Umstead Park)

Transportation: Parents should provide and arrange transportation for their children. Check-In and Check-Out are at the campsite location as mentioned above.

We need some parents volunteers to help with transportation for those who couldn't arrange transportation for their children. If you can volunteer, please make sure to indicate that on the transportation question below.


If you have any questions or concerns, please do not hesitate to email us at

Or contact us at these phone numbers:

Principal Shaikh Abdullah Khadra: (919) 618-5478

For General Information (Text or WhatsApp): (919) 917-6071

We look forward to having your children in a unique and unforgettable camping experience this year!

We ask Allah to grant you and your children success and happiness in this life and in the hereafter.

IQRA Academy — Islamic Association of Cary

Email address
Camper's Information
If you have more than one child, please enter your first child's information here. You will be asked to enter your other children's information in the "Additional Campers" section.
Camper's First Name
Your answer
Camper's Middle Name
Your answer
Camper's Last Name
Your answer
Date of Birth
Current School Grade
Is this your child's first Summer Overnight Camp Experience?
Take a look at this document to learn more about how to prepare for this camp:
Parent's Information
We would like to add you to the Parents' WhatsApp Group to facilitate communication between parents and school. If you don't have WhatsApp installed on your phone, please download WhatsApp from this link:
Father's Full Name
Your answer
Father's Cell Phone
Your answer
Father's Work Phone
Your answer
Street Address
Your answer
Your answer
Zip Code
Your answer
Father's Email address
Your answer
Mother's Full Name
Your answer
Mother's Cell Phone
Your answer
Mother's Work Phone
Your answer
Mother's Email Address
Your answer
Family Home Phone
Your answer
Medical History
Physician's Name
Your answer
Physician's Phone Number
Your answer
Pertinent Medical History
Your answer
Additional Campers
Please, follow this format in typing your additional campers information:

(1) Full name (2) Date of Birth (3) Grade (4) Any Allergies? If yes, please specify

Camper 2 Information
(1) Full name (2) Date of Birth (3) Grade (4) Allergies
Your answer
Camper 3 Information
(1) Full name (2) Date of Birth (3) Grade (4) Allergies
Your answer
Camper 4 Information
(1) Full name (2) Date of Birth (3) Grade (4) Allergies
Your answer
Camper 5 Information
(1) Full name (2) Date of Birth (3) Grade (4) Allergies
Your answer
Authorization of Consent to Treatment of a Minor
I/ We, the undersigned, parent(s) of CAMPER'S ENTERED ABOVE, a minor, do hereby authorize the Islamic Association of Cary, IQRA Academy, as agent for the undersigned to consent to any medical examination, x-ray, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is rendered under the general or specific supervision of any physician and surgeon licensed under the provision of the Medical Practices Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital.

This authorization shall remain in effect for Summer Camps period which begins on August 10th and ends on August 13th of the current year, unless revoked in writing and delivered to the Islamic Association of Cary, IQRA Academy.

We hereby give permission for my/our child(ren) to attend the Islamic Association of Cary, IQRA Academy's Program. I give the teachers, counselors, and school administration permission to take any necessary action in the event of an emergency. We have provided the pertinent medical history and allergies for all students in this form.

Enter Initials
Your answer
Liability Release
Also, I/ We, the undersigned, agree to save and hold harmless The Islamic Association of Cary, and their respective departments, organizations, boards, commissions, officers, agents, and employees from any liability whatsoever for any harm, personal injury, or property damage which my child or I may cause or suffer arising out of his/her participation in the Summer Camp. This release is effective until revoked in writing and delivered to the Principal of the School at the Islamic Association of Cary.
By signing this enrollment contract, I ______ to give permission to the Islamic Association of Cary to take pictures and videos of my child(ren) during school activities for the magazines, flyers, and the school's website and social media.
Would you like to submit a donation to improve IQRA Academy Programs?
Your donation will help improve all IQRA Academy Programs, and provide Financial Assistance to students who can't afford the fees. You can make your donation online at:
Have you paid the Summer Overnight Camp fees?
Spots are not reserved until both this form and cash/check payment are completed. (Checks must be made to the "Islamic Association of Cary")
Here is the alternative Check-In/Check-Out Procedure for Volunteer Parents and for Parents who couldn't arrange transportation to the campsite for their children. If you can't provide/arrange transportation for your children to the campsite, please, make sure you pick-up and drop-off your children from Cary Masjid.

Check-In: Depart Cary Masjid by 4:20 PM on Thursday and reach Campsite at Camp Lapihio at William Umstead Park 5:00 PM. Here is the Campsite's Location:

Late Check-in: Unfortunately, we don't have transportation assistance for late check-in on Friday. Parents must provide/arrange transportation for their children if checking in on Friday.

Check-Out: Leave the Campsite 11:30 AM - 12:00 PM and Drop-off campers at Cary Masjid. Campers arrive at Cary Masjid 12:00 - 12:30 PM

Are you able to provide/arrange transportation for your child/children to and from the campsite?
Campsite's Location:
Can you volunteer for transporting other campers in your car? (During Both Check-In and Check-Out)
If yes, please, indicate how many additional campers can fit in your car (not including your child/children):
Late Check-in
We now accept late Check-In for Students who have year-round schools and their school schedule conflicted with the camp schedule.

We'll Insha'Allah accept Late Check-In at the campsite on August 11th, Friday afternoon (after school). Check-Out will be at the same time on Sunday, August 13th, at 11:30 AM - 12:00 PM from the campsite.

All other rules, details, and fees are the same.

Do you want to sign up for Late Check-In on Friday after school?
If yes, what time are you planning to check-in at the campsite? (Please, remember to consider the distance of the campsite from your location)
Please, try to check-in your child as soon as possible. (Park Gates Open at 7:00 AM and Close at 9:00 PM)
Your answer
to indicate that you have read, agreed to, and signed this form.
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A copy of your responses will be emailed to the address you provided.
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