Address

Street Address

City

State

Postal code

In a few words, please tell us what you are hoping to achieve through the retreat

How did you hear about the retreat? *

Please indicate the names, ages, and gender of any children attending: (Name/Age/Gender)

Will any of the above children be registering for babysitting on Saturday afternoon?

Will any men (ages 16+, with guardian) in your group stay overnight for the i’tikaf program? If yes, how many?

Contribute Below:

$ 10

$ 25

$ 50

$ 100

Other amount

A $10 donation per person helps us sustain and grow this program. Your support helps cover essential retreat costs like meals, logistics, and travel.

I consent to receive informational emails, SMS notifications, alerts communication from Kufah. Message frequency varies. Message & data rates may apply. Email [email protected] for assistance.

I consent to receive marketing and promotional emails, SMS notifications, alerts communication from Kufah. Message frequency varies. Message & data rates may apply. Email [email protected] for assistance