Child Details
Please fill out all the information.

For questions/concerns, please email info@deafmuslims.ca
Email *
Child Full Name *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Deaf Identity *
Home Address *
Number + Street Name
City/Town *
Province *
Postal Code *
Name of School *
Dietary restrictions *
Any extra information about Student?
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