myMasjidHub

Registration Information

First Name *

Middle Name

Last Name *

Email Address *

Phone Number *

Date of Birth *

Gender *

Parent or Legal Guardian Full Name *

Parents or Legal Guardian Phone Numbers *

Youth Overnight Ramadan Program – Code of Conduct Agreement *

I have read, understand, and agree to abide by these conditions.

By registering, I agree that I will: Behave respectfully and uphold Islamic manners at all times. Follow all instructions given by program staff and volunteers. Participate in scheduled prayers and program activities. Remain in designated areas and not leave without permission. Follow phone and electronics guidelines. Dress modestly. Refrain from bringing prohibited items or engaging in unsafe behavior. I understand that failure to follow these rules may result in disciplinary action, including removal from the program or contacting my parent/guardian for early pickup.

Contact Information

First Name

Last Name

Email Address

Amount

$

Registration Summary

Event Who You Are Becoming (ages 16-18)

Total $55.00

Payment Details

SSL Secured Stripe Payments