Masjid Al-Rahman

ISLAMIC SOCIETY OF WESTCONTRACOSTACOUNTY

1110 36th Street, Richmond, CA94804: 510-236-8130

Registration Form for Mon-ThuAfternoonSchool Program

**Student must be well disciplined and 6-12 yr old**

**Monthly fees must be paid in 1st week of every month**

Student Name: ______Male/Female: ______

Age: ______Date of Birth: ______

Parent Guardian: ______Relationship: ______

Home Phone: ______Cell Phone: ______

Address: ______

City: ______State: ______Zip Code: ______

Additional person to be contacted in an emergency if cann’t get hold of parent/guardian:

Full Name: ______Relationship: ______

Home Phone: ______Cell Phone: ______

Address: ______

City: ______State: ______Zip Code: ______

I read the guidelines of the summer school program and agreed thereby

Parent Name: ______

Signature: ______Date: ______

Masjid Al-Rahman

AfterSchool Rules and Regulations

Assalamu Alaykum WRWB Parents:

The following are the guidelines of the AfterSchool program.

Please abide by the rules. We request parents and their child(ren)'s fullest cooperation for the smooth running of the school. Please sign this paper and fill up the accompanied form and return it to the school administrators.

1.School time: Mon – Thu; 4-6 pm

2.Student ages from6to 12 years old.

3.Monthly Fees :1st child $60, 2nd & 3rd child $30 each

4.Fees must be paid within first week of each month.

5.Parents must drop and pickup their children on time.

  1. Uniform:

Boys are required to wear Jubbas/shalwar Qamees or Kurta (any color)

Girls are required to wear proper Head-Scarf and long dress.

No tight clothing.

  1. The AfterSchool administration reserves the full right to deny admission to any student and dismiss any student on result of bad conduct in the class.
  1. Books: Students will learn "Qur’an, Fiqh, Aqaaid, Duas, Islamic History, Akhlaq & Adaab, Stories of Prophets, Seerah of Prophet Muhammad (pbuh), etc.".

Books will be available for sale from the School.

  1. Strong commitment for full attendance is required.
  1. AfterSchoolrules will be enforced strictly.
  1. AfterSchool administration reserves the right to change the above rules if deem necessary.

The undersigned hereby agree to abide by the guidelines and agree to save and hold the School, its employees, volunteers, and executive committee members harmless from any personal injuries that child ______may sustain during participation and attending the school.

Parent’s Name: ______Contact: ______

Parent’s Signature: ______Date:______

AfterSchool Administration:

Signature: ______Date:______