Fall 2019 Middle School Seerah Scouts

Registration Form

• Saturdays: Sept. 21-Nov. 9 2-4pm

• Grades 6-8

• Teacher: Nur Kose: UNC-CH Bachelor of Arts in English, Arabic Minor

• $25 Registration: All proceeds will go to ZF Programs (Email nayma@zakat.org if fee

waiver needed)

• Location: ZFNC Community Center 5410 NC Highway 55 Suite AC Durham

• To register, return the completed form to nayma@zakat.org by Sept. 8, 2019

• Circle a day to bring lunch for 20 Seerah Scouts

Sept. 21 Sept. 28 Oct. 5 Oct. 12 Oct. 19 Oct. 26 Nov. 2

Nov. 9

Student’s Name: __________________________________________ Grade: _______

Email:________________________ Phone: _________________________

Father/Guardian Information:

Father or Mother Name: __________________________________

Father’s/Mother’s Contact Number: __________________

Father’s/Mother’s Email:___________________________

Emergency/Medical Information:

If neither parent or guardian can be reached in case of an emergency, call: __________________

Does your child have any special needs, allergies, or behaviors we need to be aware of?

________________________________________________________________________________________________________
Zakat Foundation of America | P.O. Box 639, Worth, IL 60482 5410 NC Highway 55 Suite AC Durham, NC
Class Rules

• Bring notebook & pencils to every class session.

• Students must be on time each class period.

• Students may only be absent with a valid excuse.

• Foul language and disrespect to instructors will not be tolerated.

• Parents need to be at center 10 min before class is over. Late fee: $5 for every 10minutes

• Pictures may be taken in publications by Zakat Foundation of America.

• Drama club videos may be posted on various platforms, including but not limited to YouTube,
Instagram, Facebook, etc.

• Unexcused absences will automatically withdraw student from enrollment in the program.

• I/We will not hold Zakat Foundation of America, ZF staff, or ZF volunteers responsible for

any accidents that may occur.

• I/We certify that all of the information given on this form is correct and accurate to our

best knowledge. I/We promise that I/we will notify ZF, if any or all of the information

changes.

_ _________
Mother’s/Father’s Signature Date

________________________________________________________________________________________________________
Zakat Foundation of America | P.O. Box 639, Worth, IL 60482 | 5410 NC Highway 55 Suite AC Durham, NC
p: 315-383-2211 | toll free: 1.888.925.2887| www.zakat.org | nayma@zakat.org | Tax ID 36-4476244