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Sunday School Registration Form

Parent/Guardian *

First

Last

Dad Cellphone # *

Mom Cellphone # *

Emergency Contact *

E-mail *

Address *

1. Child's Name *

Date of Birth *

Gender *

Age & Grade *

2. Child's Name

Date of Birth

Gender

Age & Grade

3. Child's Name

Date of Birth

Gender

Age & Grade

Special Info (food allergies,etc…)

Photo Release *

Masjid As-Salam has the right to use photos to promote the Sunday School program, Children’s choirs and other Masjid activities ( newsletter, masjid website,etc…). I give Sunday School permission to include my child(ren) in photos used for informational or promotional purposes.

I understand *

that Masjid As-Salam Sunday School is not responsible for any injures or loss of property that the student may occur while at Sunday School. In case of an emergency in which I cannot be contacted, I authorize the Masjid to seek medical attention and administer any needed emergency procedures for the student.

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