Youth Itikhaf Program

First Name *

Last Name *

Age *

Email *

Mobile Number *

Parent/Guardian Full Name *

Parent/Guardian Mobile Number *

Lodging this form will confirm your place in the program. Please bring a sleeping bag & spare clothes. Please arrive 6pm SAT 5th SEP at Marion Masjid 658 Marion Road, Park Holme. For children aged 12 or less a parent or guardian must join with their child for the full program. *

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