Summer Camp 2019 Registration           Theme: Character Building!
This is 4 weeks summer camp for ages 5 to 13 from Monday thru Friday 10:00 AM - 3 PM - $300 per child and for ages 14 - 25  on weekends from 10 AM - 1 PM - $200 per child. The theme of the camp is Character Building and will feature  Quran (learn surah meaning and memorization with stories from Quran and Hadeeth), Islamic Studies ( Learn Islamic knowledge and mannerisms along with stories of our Prophets, Sahabas, and Muslim Heroes), Islamic Character Building Lessons, and art & craft.
Summer Enrichment (add-on) services are available from  3 - 5 PM for additional cost (see below for detail)
Please fill out the required information  below and send payment in order to reserve your spot this summer! Space is limited!
Sign in to Google to save your progress. Learn more
Email *
Student's Full Name *
Student's Age *
Student's date of birth *
MM
/
DD
/
YYYY
Parent's Full Name *
Parent's Phone Number *
Student's Phone Number
Islamic Summer Camp - Schedule: 7/8/19 - 8/2/19; Monday - Fridays, 10:00 AM - 3 PM Registration Fee: $300 total for 4 weeks *
Which Summer Enrichment (add-on) Programs are you interested in? 3 - 5 PM (for additional cost)
These add-on services are offered from Monday-Friday 3-5 PM. They can be mix and matched for the entire 4 weeks or just chosen as per week options. For example: My child is 6 years old  so I will register them for the Mon-Friday $300 session. I only want my child to do Math for Week 1 and 2, and then Urdu for week 3. This will be $275 + $300, for a total of $575.
07/08- 07/12
07/15 - 7/19
07/22 - 07/26
07/29 - 08/02
Math: $100 per week
English: $100 per week
Urdu: $75 per week
Basic Sewing Stitches and Art & Craft: $100
Public Speaking and Leadership: $100 per week
Swimming: $150 - 6 lessons (30 minutes each)
Swimming: $100 - 4 lessons (30 minutes each)
Weekend Islamic Youth Program - Schedule: 7/6/19 - 7/28/19; Sat and Sun: 10 - 1 PM Registration Fee: $200 for 4 weekends
Clear selection
Which Enrichment (add-on) Programs are you interested in for weekends. Registration Fee: $160; Schedule: 7/6/19 - 7/28/19; Sat and Sun: 2 - 4 PM
Check
Swimming: 6 lessons (30 minutes each)
Science
Basic Sewing Stitches and Art & Craft
Math
Urdu
Language Arts
Public Speaking and Leadership
If swimming is selected above, please list the days/ time you prefer for swimming sessions and we'll reach out to you finalize the schedule.
Are you in need of after-care for your child? ($10 per day from 4-5:30 PM) *
Please provide an emergency contact name *
Please provide the emergency contact phone number. *
Please list any medications your child will bring. (EpiPen, timely oral pills, etc.) *
Does your child have any allergies? *
Registration will not be complete until payment has been made and processed.
Payment options:
1)  Venmo app email: simply4smarts@gmail.com    (https://venmo.com/).
2) Check - Mail to "8125 Mt Vernon Memorial Hwy, Alexandria, VA, 22309" payable to "Syra".
3) In person at the above address.
 For additional information email: simply4smarts@gmail.com or call 703-582-5063. Thank you.

A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms