Please fill out the form below to register your child(ren) for Al-Ihsan’s 2020 Summer Youth Program
.
Email
Parent/Guardian Full Name
*
Primary contact person
Parent/Guardian Phone Number
*
Parent/Guardian Email
*
Home Address
*
Home Phone
If applicable
City, Province
*
Number of Students
One
Two
Three
Four
Five
If you are registering more than 5 children, please fill out the form a second time. Please fill out the sections below which apply (according to the number of children)
1- Student One Full Name
*
Student 1: Date of Birth
*
1- Gender
*
Male
Female
1 Health Card Number
*
1 Medical Conditions/Allergy Information
*