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CVIC Weekend School - Saturday Enrollment/Registration form
Note: Please fill entire form in order to enroll.
Parent information
Parent Email Address
***Valid email address required***
:
Parent Full Name:
Parent Phone #:
Emergency contact information
Emergency ContactName:
Emergency Contact Phone #:
Photography Consent
Photography Consent:
--Please Select--
Yes
No
Please enter your Child(ren) Information*
Fee will be auto calculated:
Click "Add new child" button below to add your child(ren)
Fee for 1 Child : $600
Fee for 2 Children : $900
Fee for 3 or more Children : $1,200
Total Amount($):
Add new child
×
CHAGRIN VALLEY ISLAMIC CENTER - Add/Update Latest Update Section
Id:
Child Full Name:
Date of Birth:
Allergies:
Has your kid attended the class last year?:
-- Please select --
Yes
No
Submit
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