AL HAQ MASJID EDUCATION

Saturday Islamic School

Parent Registration Form

Program Hours: Every Saturday, 10:00 AM – 1:00 PM
Ages: 5-12 years (for now)
Venue: AL HAQ MASJID EDUCATION, 1627 S Cline Ave, Griffith, IN 46319

1Student Information

Student Full Name *

Date of Birth *

Age *

Current School / Grade

Home Address *

City / State / ZIP *

2Parent / Guardian Information

Parent / Guardian 1 *

Phone *

Email *

Parent / Guardian 2

Phone

3Emergency Contact

Emergency Contact Name *

Relationship *

Phone *

4Special Accommodation / Student Needs

Please let us know about any special accommodation, learning support, communication needs, allergies, dietary concerns, or other information that would help us support your child.

Details

5Child & Parent Photos / Authorized Pick-Up

Please provide a recent photo of your child, and of each parent/guardian listed above. These photos are used by staff for child identification and safe pick-up.

Child's PhotoChoose a photo (JPG or PNG)…Upload

Parent/Guardian 1 PhotoChoose a photo (JPG or PNG)…Upload

Parent/Guardian 2 PhotoChoose a photo (JPG or PNG)…Upload

Pick-Up Policy

Your child may be picked up by a parent/guardian or another person whose photo has been provided with this registration form. Any other family member or person who is not included in the photos provided must have special permission from the parent/guardian in advance, and may also be required to show valid identification.

6Photo, Video & Social Media Consent

I give permission for AL HAQ Masjid Saturday Islamic School to photograph and/or record my child during school activities. I understand that approved photos and videos may be used for school communications, community announcements, educational promotion, and the Saturday Islamic School's social media platforms.

Yes — I give permissionNo — I do not give permission

Parent/Guardian Signature (type full name) *

Date *

7Program Information

Curriculum: Age-appropriate Islamic education for children ages 5-12 (for now), including Qur'an, Tajweed, Islamic Studies, and Arabic Language — all in one Saturday program.

Monthly Tuition: $70 per child, paid via Zelle once enrollment is confirmed — we'll send a private link with payment instructions.

8Parent Agreement

I understand that this is a Saturday Islamic education program. I agree to provide accurate information, follow the school's registration and pick-up procedures, and promptly notify the administration if any information changes.

Parent/Guardian Signature (type full name) *

Printed Name *

Best Contact Phone *

Date *

By submitting, you agree to be contacted by Al Haq Masjid Education regarding enrollment, and you'll receive a $70/month tuition payment link by email once your registration is reviewed.