Welcome to The Muraqaba School Summer Camp Enrollment Form. Kindly read the following before completing the form:

Summer Camp Hours:

Monday -Thursday, 10:15 AM - 2:15 PM
June session: June 8-25
July session: July 6-23

This form cannot be saved, so you will have to enter it all in one sitting.

We offer summer camp for KG-5th grade (KG applicants must be 5 years old by Sept 1st, potty trained, and able to use the bathroom and dress themselves independently).
Summer Camp is a more relaxed environment than our normal school year. We have a balance of fun, enrichment activities, and meaningful hands-on projects. We do not have an admissions vetting process for summer - anyone within the eligible age range can apply. However, parents should note that we do not offer PreK programs (contact RARE Learning for PreK).
We expect parents to teach their children acceptable behavior standards and self-regulation. Students are expected to demonstrate positive behavior and understand they are in an Islamic environment. Staff work with parents and students to redirect behaviors as needed. Leadership reserves the right to ask a student to unenroll if the camp environment is not a good fit for them to thrive or they are disruptive/harmful to others.

Family Information

Mother First & Last Name *

Father First & Last Name *

Mother Contact Phone *

Father Contact Phone *

Mother Email *

Father Email *

How many children are you enrolling? *

Child 1 Information

Child 1 First Name *

Child 1 Last Name *

Child 1 Age *

Child 1 Date of Birth (MM/DD/YYYY) *

Child 1 will be in which grade starting Aug? *

KG (must be 5 years old by Sept 1st)

1st

2nd

3rd

4th

5th

6th

Child 1 Race (asked for future government grant and other documentation purposes) *

White

African American

Asian

MENA (Middle Eastern/North African)

Native American

Pacific Islander

Hispanic

Has Child 1 ever been suspended or denied re-admission into a school or other educational program? *

Yes

Child 1 - List any allergies and/or medical needs *

Child 2 Information

Child 2 First Name *

Child 2 Last Name *

Child 2 Age *

Child 2 Date of Birth (MM/DD/YYYY) *

Child 2 will be in which grade starting Aug? *

KG (must be 5 years old by Sept 1st)

1st

2nd

3rd

4th

5th

6th

Child 2 Race *

White

African American

Asian

MENA (Middle Eastern/North African)

Native American

Pacific Islander

Hispanic

Has Child 2 ever been suspended or denied re-admission into a school or other educational program? *

Yes

Child 2 - List any allergies and/or medical needs *

Child 3 Information

Child 3 First Name *

Child 3 Last Name *

Child 3 Age *

Child 3 Date of Birth (MM/DD/YYYY) *

Child 3 will be in which grade starting Aug? *

KG (must be 5 years old by Sept 1st)

1st

2nd

3rd

4th

5th

6th

Child 3 Race *

White

African American

Asian

MENA (Middle Eastern/North African)

Native American

Pacific Islander

Hispanic

Has Child 3 ever been suspended or denied re-admission into a school or other educational program? *

Yes

Child 3 - List any allergies and/or medical needs *

Child 4 Information

Child 4 First Name *

Child 4 Last Name *

Child 4 Age *

Child 4 Date of Birth (MM/DD/YYYY) *

Child 4 will be in which grade starting Aug? *

KG (must be 5 years old by Sept 1st)

1st

2nd

3rd

4th

5th

6th

Child 4 Race *

White

African American

Asian

MENA (Middle Eastern/North African)

Native American

Pacific Islander

Hispanic

Has Child 4 ever been suspended or denied re-admission into a school or other educational program? *

Yes

Child 4 - List any allergies and/or medical needs *

Parental Consent

Emergency Contact Info - List the Name, Phone, and Relationship of 1-2 emergency contacts that are authorized to pickup your child(ren). E.g. John Doe, 123-456-7890, Grandpa *

The school may use student photos or videos for promotional purposes on the school’s website, social media, newsletters, emails or other marketing materials. *

Yes, I give permission for my child(ren)

No, I do not give permission for my child(ren)

The Muraqaba School Summer Camp reserves the right to recommend or require withdrawal if it determines that the program is no longer an appropriate fit for the student or family *

Yes

By submitting this form and signing up for texts, you consent to receive SMS about charity from The Muraqaba School at the number provided, including messages sent by autodialer. Msg & data rates may apply. Msg frequency varies. Unsubscribe at any time by replying STOP. Reply HELP for help. Privacy Policy https://www.muraqabaschool.org/donor-privacy-policy *

Yes

I, the undersigned, attest that all the information provided is accurate to the best of my knowledge at the time of application. I understand it is essential I communicate all details that may affect the student(s) experience at The Muraqaba School Summer Camp. Any false, inaccurate, incomplete, or misleading statements and information can be grounds for dismissal of the application. I agree to notify The Muraqaba School Summer Camp team of any changes in information. *

Yes

Parent Signature *

Clear

Terms & Waiver: I understand that any unsafe or inappropriate behavior of my child(ren) that endangers personal or community safety or wellbeing can be a cause for removal from summer camp (payment non-refundable). I, the undersigned, hereby hold harmless, waive and release The Muraqaba School and Islamic Center of Frisco, their personnel, organizers, representatives, and volunteers from liability. I have read, understand and agree to adhere to these terms.

Payment

Are you enrolling for June, July, or both sessions for your child(ren)? *

June only

July only

Both June & July

Check the box, choose the correct number of students in the quantity field, choose the correct # of months (e.g. 1 month if either June OR July / 2 months if enrolling for BOTH June & July sessions) *

Summer Camp

$400 per child per month (price includes supplies & enrichment activities)

$400

*100% secure & safe payments*

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