Saturday School Enrollment Contract

The longstanding Saturday School program, a cornerstone of Islamic education for children, provides children aged 5–15 with an engaging and supportive environment to learn about the Quran and Islamic values. The formative years are an ideal time to cultivate a strong foundation of faith and a love for Islam in a structured classroom setting while fostering meaningful connections with peers. Our dedicated teachers nurture spiritual growth and instill God-consciousness through the teachings of Islam and the Quran. Additionally, students develop Farsi language skills, enriching their understanding of both faith and culture.

Please note: A separate registration form must be completed for each child you are enrolling.

Is your child a returning student?
YesNo

Student Information

Child’s First Name*

Last Name*

Gender*

Date of Birth*

Address*

City*

Zip Code*

School currently enrolled in

Current Grade Enrolled In*

Does your child have an IEP or 504 Plan?
YesNo

If yes, please provide details:

Sibling(s) attending the Weekend Program:

Parent/Guardian Information

Father’s First Name*

Father’s Last Name*

Email*

Phone*

Occupation (optional)

Mother’s First Name*

Mother’s Last Name*

Email*

Phone*

Occupation (optional)

Emergency Contact Information

Emergency Contact #1

Phone

Emergency Contact #1 Relationship

Emergency Contact #2

Phone

Emergency Contact #2 Relationship

Authorized Pick-Up #1

Phone

Authorized Pick-Up #2

Phone

Medical Information

Does your child have any known allergies?
YesNo

If yes, please specify:

Does your child have a medical condition requiring attention?
YesNo

If yes, please specify:

Preferred medical facility:

Name of Physician / Pediatrician:

Phone number:

Home Language Information

Your child’s native language:

Language your child learned when he/she first began to talk:

Language your child most frequently uses at home:

Language most often used by the adults at home:

Can your child read the Quran?
YesNo

Can your child read/write Farsi?
YesNo

Liability Release

By signing this contract, I/we give permission for the student(s) named above to participate in all school activities, including sports. I/we waive and release ARK Academy, along with its officers, agents, and employees from any claims of liability for injuries incurred by the student at school or during any school activity.

I/we accept and support the mission, policies, standards of discipline, and the rules of behavior as adopted by the school.

I/we grant permission for ARK Academy’s employees or authorized representatives to take photographs or videos of the student during school activities. I/we also consent to the use of these images or videos for school-related purposes, including but not limited to publications, promotional materials, advertisements, and social media platforms. I/we understand that the school will use these images responsibly and will not disclose identifying information without prior consent.

I/we understand that it is my/our responsibility to promptly notify the school office of any changes to my/our address or telephone number.

I/we have read, understand, and agree to all the terms and conditions of this enrollment contract. By signing this contract, I/we represent and warrant that I/we have full authority to sign and enter into this agreement.

Also, I/we, the undersigned, agree to save and hold harmless ARK Academy, and its board, officers, agents, and employees from any liability for harm, personal injury, or property damage that my child or I may suffer as a result of his/her participation in the program. This release is effective until revoked in writing and delivered to the Principal of the School.

I verify that the information contained in this document is true and correct to the best of my knowledge.

Parent Signature

Signature*

Date*

Saturday School Enrollment Contract

Student Information

Parent/Guardian Information

Emergency Contact Information

Medical Information

Home Language Information

Liability Release

Parent Signature

Location

California

Contact Us

info@arkacademyoc.org

Stay Informed