ICM Elementary/Middle School Ramadhaan Rush

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Alsalaamu 'alaikum wa rahmatu Allaahi wa barakaatuhuu,

Please fill out the form below to register for the Summer Ramadan Rush 2014 Program.

Days/Dates: Monday-Thursday, June 16 - July 24, 2014

Times:
- Pre-Ramadhaan, 12:30 p.m. - 5:00 p.m.
- Ramadhaan, 1:30 p.m. - 5:00 p.m.

Planned Activities: Qur'aan discussions and reflections, sports and hands-on activities, outings, and Islaamic Education

Start Date: Monday, June 16, 2014, inn shaa'a Allaah.

Volunteering Opportunity: Please volunteer even if once a week.

Cost (both, together, discounted to $145):
- Pre-Ramadhaan Portion: $75 (if paid individually)
- Ramadhaan Portion: $95 (if paid individually)

If you are able to, and wish to, donate, please do so in the form of money, time, supplies, etc., wa baaraka Allaahu feekum.

Contacts: Brother Mahen M. Khan, Brother Aatif Abdul-Qadeer, Sr. Tara Olhoft, Br. Akram Al Kholaidi

Ahsana Allaahu ilaikum.

Participant's Full Name *

Participant's Email (if different than parent's) *

Participant's Phone Number *

Gender *

Male/Boy

Female/Sister

Pre-Ramadhaan Portion ($75), Monday - Thursday, June 16 - June 26

Ramadhaan Portion ($95), Monday - Thursday, June 30 - July 24

Both Portions (Pre-Ramadhaan + Ramadhaan) ($145)

Parent's Name *

Parent's Contact Number *

Parent's Email Address *

Allergies? *

Volunteering Availability!

If you are able to volunteer (and/or would like a discount), please select which days you will commit to.

Pre-Ramadhaan (6/16-6/26): Mondays (12:15 - 5:15 p.m.)

Pre-Ramadhaan (6/16-6/26): Tuesdays (12:15 - 5:15 p.m.)

Pre-Ramadhaan (6/16-6/26): Wednesdays (12:15 - 5:15 p.m.)

Pre-Ramadhaan (6/16-6/26): Thursdays (12:15 - 5:15 p.m.)

Ramadhaan (6/30-7/24): Mondays (1:15 - 5:15 p.m.)

Ramadhaan (6/30-7/24): Tuesdays (1:15 - 5:15 p.m.)

Ramadhaan (6/30-7/24): Wednesdays (1:15 - 5:15 p.m.)

Ramadhaan (6/30-7/24): Thursdays (1:15 - 5:15 p.m.)

Payment Plan Desired? *

Will you need to have the fees submitted in installments or reduced in amount?

Yes

Donations

If you would like to donate towards the program (including towards others' attendance costs), please indicate amount.

$10

$20

$30

$40

$50

Other:

Clear selection

Registration Fee Submitted/Discussed?

Program-dependent: $75 or $95 or $145 plus any donation amount from above. Registration is incomplete until payment is received/approved, and we will match payments received with the answers in the database for this form (for record keeping), inn shaa'a Allaah. Baaraka Allaahu feekum.

Yes - Paid Brother Aatif Abdul-Qadeer

Yes - Paid Brother Mahen M. Khan

Clear selection

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