CHILDCARE REGISTRATION

Thank you for registering to attend A Journey Into Islam 2017. To ensure an enjoyable, stress-free evening (even though we love kids!), we will be offering childcare services for any guests, exhibitors or volunteers with children under the age of 13.

As you enter the Az-Zahraa Islamic Centre for registration, a volunteer will be present to take your child / children upstairs to our childcare area. Childcare will be provided between 5:30-10:00 PM and children will be under supervision at all times. We will also provide refreshments – therefore, it is important that you inform us of any allergies or dietary restrictions in the form below.

For all registered attendees (community members and guests), childcare will be free. However, please note that pre-registration for childcare is mandatory.

Child Name (1)

First Name

Last Name

Child Name (2)

First Name

Last Name

Child Name (3)

First Name

Last Name

Parent’s Name

First Name

Last Name

Parent’s Cell Phone Number

(###)

###

####

Parent’s Email Address

Allergies / Dietary Restrictions

If you are registering multiple children for childcare, please indicate the child’s name next to their allergy or dietary restriction.