MYCC Girls Program Registration

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As-Salaamu 'alaikum wa rahmatullaahi wa barakaatuhuu

This form is for MYCC's youth program for girls ages 5-12.

The program will consist of an Islamic talk, sports/activities, and social time.

The program will be every Saturday after Duhr prayers, insha'Allah.

Participant's Full Name *

Participant's Age *

Parent's Full Name *

Parent's Email *

Parent's Phone Number *

Emergency Contact *

Emergency Contact Phone Number *

Allergies (Please use the box below to describe any special care needs, dietary requirements, allergies or medical condition, if none put N/A) *

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