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Inspire A Learner
Inspire A Learner
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Home
About
Programs
Monthly Packages (Age 2-5)
Summer Camp Packages
Spring Break Packages
Contact
My account
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Username
*
Password
*
Repeat Password
*
First Name
*
Last Name
E-mail
*
Phone Number
*
Contact Info
Program Selection
-- Qur'an Learning
-- Islamic Learning Sessions
-- Recreational Activities
Number of Children
You can sign up to 3 siblings online!
Child’s Name
*
Child’s Birthday
*
2nd Child's Name
*
2nd Child’s Birthday
*
3rd Child's Name
*
3rd Child’s Birthday
*
Start Date
*
Preferred Session Schedule
*
-- Monday
-- Tuesday
-- Wednesday
-- Thursday
-- Friday
-- Saturday
-- Sunday
-- Morning
-- Afternoon
-- Evening
Health and Safety Information
*
None
Allergies (Specify below)
Medical Needs (Specify below)
If selected, please provide details
*
Emergency Contact Name
*
Emergency Contact Phone
*
Relationship to Participant
*
Liability Waiver
*
-- I read the policies and I accept
I acknowledge that participation in activities at Inspire A Learner involves certain risks. I release and hold harmless Inspire A Learner, its staff, and volunteers from any liability arising from injury, loss, or damage incurred during participation.
Cancellation and Rescheduling Policy
*
--I Accept
At Inspire A Learner, we value the time spent together. Registrants needing to reschedule their time slots are expected to submit their request 24 hours prior to the original class time. Registrants wishing to cancel a session must also notify us within 24 hours. Registrants are subject to paying the full cost of a time slot for cancellations and/or rescheduling made less than 24 hours in advance.
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