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Islamic Center of Pittsburgh

4100 Bigelow Blvd, Pittsburgh, Pennsylvania 15213, USA

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2024 Youth Summer Quran Intensive

22
JUL

11:00 AM

08
AUG

3:00 PM

Program Fee:

One Time: $150.00

Offering Days: Monday, Tuesday, Wednesday, Thursday

View Details

1 Parent Information

First Name *

Last Name *

Phone Number *

Email Address *

Address1 *

Address2

Country *

State *

City *

Zip Code *

Cell Number

2 Student Information

Primary Contact as First Registrant

Registrant Name*

Email Address

Age

Gender

Choose Program

Photo Permission: May ICP photograph your child (Y/N)*

Does the Child have any allergies or special needs (Explain)

Other Parent's Name and Number (or Emerg. Contact)*

Assess your child's existing knowledge of Quran*

+ Add More Registrants

3 ICPSummerCamp

You can help save us on credit card transaction fees by selecting the eCheck/ACH option. Jazak'Allah!

Payment Method

eCheck/ACH titleIcon

Credit/Debit Card

Name on Credit Card *

Credit Card Number*

Expiry Date*

CVV Code*

Bank Name

Name on Account *

Account Number*

Routing Number*

Account Type*

Monthly Recurring

Recurring Start Date*

Number of Months*

For Lifetime

Please note: You will incur a $1 charge if the recurring start date is not current date in order to verify the payment details provided. This charge will not be credited back to your account and you will receive a test transaction receipt for this amount.

Consent * Do you give Islamic Center of Pittsburgh consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

Agree Decline

Promotion Code Promotional Price Applied

Since you purchased free Ticket No Payment Required.

Comments

Payment Summary

Program Fee

Total Registrants

Total Cost

Acknowledgement

By registering, you acknowledge that you will follow all the guidelines detailed in the Parent Handbook.

Islamic Center of Pittsburgh

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2024 Youth Summer Quran Intensive

1 Parent Information

2 Student Information

3 ICPSummerCamp

Payment Summary

Acknowledgement

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