Al-Quran Academy Summer Camp 2022

3 weeks: June 13th - June 30th 2022
Monday - Thursday from 10:30am - 1pm

Masjid Al-Qur'an Academy is excited to offer the popular Summer Camp program again this year! Your kids will be able to enjoy indoor & outdoor activities & learning, designed specially for their age group.

Our camp includes indoor learning, 2 off site field trips and age appropriate outdoor actvities (ie gardening, archery, animal husbandry and more). We will also have an end of program bond fire for the whole family on Friday June 24th at dusk!

Snacks will be provided (if your child has special dietary needs or allergies, please send a snack with them to the masjid).

What recreation activities are offered?
All ages: In addition to off site fieldtrips we offer gardening, bee keeping, archery, animal husbandry and more...

Do you have time to be a Parent Volunteer?
If you would like to help supervise/chaperone activities, or be a carpool driver, please let us know! Indicate your availability in the Registration form below!

- For Kids age 5-16

Summer Camp Fees (per child)

All Inclusive Registration Fee: $100
+ Includes daily snacks and lesson materials, 2 off site field trips, recreational activities including archery

Fee without Archery cost: $85
+This option includes all areas listed above including recreation activities other than archery

***50% off for students previously or currently enrolled in Academy 21/22 academic year.
***Fees are due at the time of registration. See "Pay Here" button at bottom of registration below.
It is not our intention that any child should miss out as a result of financial hardship. Please inquire about financial assistance or payment plan options with
Imam Shafique at 414-795-4677.

Register Here

Please read the entire form carefully when filling it out. If you need to leave a required field empty, please write "N/A".

Medical Release & Liability Waiver:
My child(ren) named below has my permission to participate in activities sponsored by Masjid Al-Qur'an (aka Al Qur'an Foundation). I understand that this may involve physical activities including beekeeping, gardening, and sports such as volleyball, basketball, pickleball, etc.

PLEASE NOTE that bees are being housed at Masjid Al-Qur'an and there is a risk of bee stings. Please advise us if your child has any allergies, and provide the appropriate antihistamine or EpiPen if needed. Masjid personnel are NOT responsible for providing or administering any medications to the children. I authorize adult personnel from the Masjid to release the medical information included in this form to a third party medical provider in the event of an injury or other medical emergency. I also certify that the child named in this release is healthy and able to participate in the activities at the Masjid.

Media Waiver:
Masjid Al-Qur'an staff & volunteers may take photos of camp participants for promotional purposes. If you do not want your child(ren)'s photo taken, please contact the program admin (masjidalquran414@gmail.com) or Imam Hafiz Shafique (414-795-4677) and we'll be happy to accommodate.

* Indicates required field

Check box to confirm *

I affirm & accept the above statements & waiver.

Parent & Emergency Contact Info

Primary Parent/Guardian Contact Name *

First

Last

Email *

Phone Number *

Interested in being a Parent Volunteer? *

Secondary Parent/Guardian Contact Name *

First

Last

Email *

Phone Number *

Interested in being a Volunteer? *

Emergency Contact Name *

First

Last

Phone Number *

Relationship to Child *

Medical Provider Info

Please provide basic info on your medical & insurance providers for the child(ren) being registered.

Primary Care Provider (Doctor or Clinic Name) *

Phone Number *

Medical Insurance Provider *

Registration Options (per child) *

All Inclusive $100 Everything except archery $85

Child Info

You can register up to 4 kids per application. If you want to enroll more kids, you'll submit this form & fill out a new form for the remaining children.

1st Child's Name *

First

Last

Any Allergies/Medical Conditions we should know about? *

Medications we should be aware of? *

Age *

2nd Child's Name *

First

Last

Any Allergies/Medical Conditions we should know about? *

Medications we should be aware of? *

Age *

3rd Child's Name *

First

Last

Any Allergies/Medical Conditions we should know about? *

Medications we should be aware of? *

Age *

4th Child's Name *

First

Last

Any Allergies/Medical Conditions we should know about? *

Medications we should be aware of? *

Age *

I hereby give permission for my child to participate in the camp activities noted above. If there is any injury, I give permission for staff to provide first aid, and if necessary to seek emergency medical assistance. I hereby agree to indemnify and hold harmless the staff and volunteers of the Masjid who chaperone my child(ren) during this program. The Medical Information and Release form to be kept on file by Masjid Al-Qur'an.

PLEASE NOTE: Registration is NOT complete until payment is recieved. Please acknowledge below your intent to pay or to discuss payment with Hafiz Shafique (414-795-4677) before start date. We appreciate you helping us to better plan and fund this program by paying in advance. Thank you. *

Submit Registration

PAYMENT IS DUE AT TIME OF REGISTRATON...PLEASE PAY NOW
Please select "Al Quran Academy" in the drop down menu shown once you hit the button below.

Pay Here

3 weeks: June 13th - June 30th 2022
Monday - Thursday from 10:30am - 1pm

Summer Camp Fees (per child)

Register Here

Parent & Emergency Contact Info

Medical Provider Info

Child Info

Education

About

Contact Us

3 weeks: June 13th - June 30th 2022Monday - Thursday from 10:30am - 1pm

Summer Camp Fees (per child)

Register Here

Parent & Emergency Contact Info

Medical Provider Info

Child Info

Education

About

Contact Us

3 weeks: June 13th - June 30th 2022
Monday - Thursday from 10:30am - 1pm