Welcome to Masjid Madeena Islamic Center

Registration

Registration

Register your kids and yourself against a program your interested in, fill out a below form and send it to us. We will get back to you.

Note: Registration code can be receive by contacting Imam or by sending email to [email protected] for registering your kids.

Student Information:

Education Level:

Parent Information:

Emergency Contacts:

(must be someone from a different household)

I testify that the above information is correct. I also agree to ensure that my child/children will abide by the guidelines contained in the Rules and Regulations sheet.

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