Learn To Read Quran For Children Registration For children ages 4 and up. With multiple levels to accommodate the child’s reading level. Student Name: Date of Birth: Age: Student Name 2: Date of Birth 2: Age 2: Student Name 3: Date of Birth 3: Age 3: Student Name 4: Date of Birth 4: Age 4: Student Name 5: Date of Birth 5: Age 5: Father's full name: Phone#:Email Address: Mother's full name: Phone#:Email Address: Home Address:Any Allergies? ---NoYesIf yes state the details: Any medical conditions, or Behavioral issues:---NoYes State the condition: I, , do not hold the IECPA or Tajan Quran Institute 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 Street, 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 Tajan Quran Institute of IECPA.I hereby allow the staff and/or volunteers of the Tajan Quran Institute 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.Class platform choice: OnlineIn PersonI agree! that tuition payments are due by the fifth of every month and once the payment is late then I will have to pay for three months in advance in order for our child or for me to be able to continue attending classes.To complete registration please pay the registration fee which is the first month tuition.