MAS Youth Camp Registration Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Camp Registration is now closed – You are welcome to Waitlist, if there is space we will notify you. JazakAllah Khayran. Number of Campers (Including Siblings) | You are now registering for the waitlist *OneTwoThreeFirst Camper InformationFirst Camper Name *FirstLastFirst Camper Sex *MaleFemaleFirst Camper Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920First Camper T Shirt Size *SmallMediumLargeXL2XL3XL4XLFirst Camper Medical Concerns or Food AllergiesSecond Camper Information Second Camper Name *FirstLastSecond Camper Sex *MaleFemaleSecond Camper Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Second Camper T Shirt Size *SmallMediumLargeXL2XL3XL4XLSecond Camper Medical Concerns or Food AllergiesThird Camper Information Third Camper Name *FirstLastThird Camper Sex *MaleFemaleThird Camper Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Third Camper T Shirt Size *SmallMediumLargeXL2XL3XL4XLThird Camper Medical Concerns or Food Allergies *Parent/Guardian InformationParent/Guardian Name *FirstLastParent/ Guardian Email *Parent/Guardian Phone *Parent/Guardian Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmergency ContactName *FirstLastPhone *Individual Ticket – Early Registration Price *Price: $300.00Two Siblings – Early Registration Price *Price: $550.00Three siblings – Early Registration Price *Price: $750.00012345678910Transportation (Our buses are now full, if there are spaces that open up we will notify you)Yes, we will use the bus ride from Masjid Al-Ansar (OC) or Ar-Rahman Islamic Center (Fontana) for a $40 per camperTransport One CamperTransport Two Campers Shirt you. First Transport Three campersMAS Camp Waiver – Release of Liability Form – View Right click and click Open in New Tab or click with the middle wheel button I Consent to the MAS Youth Camp Waiver forms – Signature Below * Clear Signature By signing this Form you agree to all the conditions mentioned in MAS Camp Waiver Release of Liability FormSigned Waiver Form Upload 1Signed Waiver Form Upload 2Coupon Apply Total$0.00Square Payment (Required to Complete Your Camp Registration)CardName on CardSubmit
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