Summer Camp 2025 Registration

Student First Name *

Student Last Name *

Date of birth *

Gender *

Guardian's Full Name *

Phone *

Email *

Address *

City *

State *

Postal Code *

Emergency Contact *

Relationship To The Student *

Emergency Contact Phone Number *

Student Health Information

Is your child physically able to take part in any activities? *

Yes

If No, please explain your child's limitations. School may require a doctor's note.

Does your child suffer from any chronic disease or disability? *

Yes

If Yes, please state the disease or disability and any special instructions school to be able to help your child.

Does your child have any allergic reactions? *

Yes

If Yes, please list all the details of allergic reactions.

Are any of the allergies LIFE THREATENING?

Yes

If yes, please explain.

Is your child under a doctor's care, other than routine visits? *

Yes

Is your child being given medication on a continuous basis? *

Yes

If your child needs to take medication at school, please inform the school office.

Stay at Home *

Please stay at home if your child experiences any of the following, to protect the safety of our students and staff:

Fever
Persistent cough
Difficulty breathing
Vomiting or diarrhea
Unexplained rash
Sore throat, especially with fever or swollen glands
Severe headache
Persistent ear pain
Red, itchy, or crusty eyes
Loss of taste or smell

It's essential to consult a healthcare provider for further advice and to determine if medical attention is necessary.

Drop Off & Pickup Policy *

Monday - Wednesday, drop off at 10:00 am, pick up at 3:00 PM

Thursdays & Saturdays drop off & pick up times based on the activity of the day

Photo/Video and Sample Release Form

Throughout the program, there may be occasions when the staff, the media, or other organizations, with the approval of the administration, may take photographs or audio/video recordings of students. Additionally, students' work may be displayed internally in classrooms and hallways for educational purposes and as a historical record.

Al Noor Foundation also uses photographs of students for publicity and educational purposes. We promote our programs through the Al Noor Foundation website, presentations, the internet, and other media sources.

I hereby grant Al Noor Foundation permission to use my child's photographs and/or videotaped images for the purposes mentioned above. I do this with full knowledge and consent, and I waive all claims for compensation for use or for damages. I understand and agree that Al Noor Foundation may use these photos and/or videotaped images unless I revoke this authorization by notifying the camp manager in writing. *

I DO give my permission to include my child's image in videotapes or photos as he or she participates in class and camp events.

I DO NOT give my permission to include my child's image in videotapes or photos as he or she participates in class and camp events.

Summer Camp Registration Fees

Program Registration Fee: $350 (non refundable)

An invoice will be sent to you by email & text message. Payment must be submitted within 7 days of receipt.

Acknowledgment

I agree to all the submitted terms & conditions provided by Al Noor Foundation - Summer Camp enrollment application.

By providing my phone number & email address, I agree to receive any announcements or invoices by emails and text messages.

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Signature *

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