Sunday School Registration 2019/2020 | Islamic Education Center of PA

Islamic Sunday School

6635 Tilghman Street Allentown PA 18106 Phone (610) 351-1666
School Registration Form 2019/2020, 1440/1441

Deadline

Deadline is September 1 s t , 2020 or 120
students school capacity is maximized,
whatever comes first.

Please fill in your Child/ Children information

Last Name *:	Father Name *:	Mother Name *:
Home Address* :

Home Phone# *:

Cell Phone# *:

Cell Phone 2#:

Email *:

Student Name *:	Age *:	New/Returning *:	Grade *:
Student Name:	Age:	New/Returning:	Grade:
Student Name:	Age:	New/Returning:	Grade:

We encourage parents to volunteer. Please check the option that fits you the best, Please respond by August 12^th, 2019 if you intend to volunteer.

Quran Teacher

Arabic Teacher

Islamic Studies Teacher

Food Server

General Needs

(check-in/out clean up)

Emergency Contact*:

Relationship to Child *:

Emergency Contact Phone Number*:

I, , do not hold the IECPA Sunday school staff and volunteers responsible for any harm or injury to my son/ daughter during the time they are on the premises of the Islamic Education Center, located at 6635 Tilghman St, Allentown PA 18106. I will be fully responsible for any and all damages and/or vandalism that are caused to the building, classrooms, supplies or equipment used by staff that would have been caused by any negligence or abuse by my children. My child (or Children) and myself will further comply with the rules and regulations set by the Sunday Islamic School of IECPA.

I here by allow the Staff and/or Volunteers of the Islamic Sunday School of the IECPA in the case of an emergency to one or more of my children to administer CPR, First aid and/or contact Emergency personnel or to take my child to an Emergency room in which case I will be fully responsible for the costs of the given treatments and/or emergency care fees.

Known Behavioral:
or Moral Medical Issues:

School Registration Dues are $200 per child for the school year, with a family max of $600.
For volunteer teachers, for the first year volunteer there is a 50% discount, for two years or more 100% discount*

If a payment schedule is needed, the balance due can be divided into 3 equal installments. Dates of the installments are inputted in the boxes across. All Payments MUST be completed by 31-Dec-2019.

Parent/ Guardian Signature *::

Date Signed:

Staff Member Helping: