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Student Info

Student Full Name *

First

Middle

Last

Student ITS Number *

Gender *

Age *

Minimum age for this year's summer camp is 11.

Birth Date *

Finishing Grade *

Select the grade which the child just finished.

Birth City *

Birth State *

Birth Country *

Student Nationality

Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Student Photo *

Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera

Camera Preview

To be used for Student ID card. White background 2in x 2in

Parent Info

Father Name *

First

Last

Mother Name *

First

Last

Father Contact Number *

Father Email *

Mother Contact Number *

Mother Email *

Family/Guardian in Houston

Enter the name only if applicable. If not, you may leave this field blank.

Phone

Address

Address Line 1

City

State

Transfer Houston Shirt

Medical Info

Medical Conditions (if any)

Please mention if we should be aware of any medical conditions of the child such as allergies, special learning needs, etc.

Insurance Status *

Insured
Not Insured

Insurance Card *

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Please upload a copy of your insurance card with the child's name clearly stated on it.

Permission for emergency medical care *

By selecting “Yes,” you authorize Mahad al Zahra – Houston and its designated staff to obtain and consent to any necessary emergency medical care for your child in the event of a medical emergency during the Quran Summer Camp.

Quranic Background and Goals

Can the student read Quran fluently?

Yes
Somewhat
Beginner

Current Hifz Position (Juz)

Selected Value: 0

Where is your child currently enrolled for Hifz classes?

Madrasah
Online eLearning
Private Classes
Other

What is your goal for this Quran camp?

Improve Tilawat fluency
Strengthen Tajweed
Revise previous memorization
Complete a Marhala Ikhtebaar

Hunar Club – Skills Elective Program

Hunar Club is an exciting elective program where students choose one skill to master over 9 immersive sessions. We're currently considering offerings in calligraphy and introduction to artificial intelligence, and we'd love your input! Please suggest skills or interests your child would like to explore. Based on parent feedback, we'll finalize 3-4 skills for students to choose from. This is a great opportunity for your child to discover a new passion and develop confidence in a structured, hands-on learning environment.

Suggestion One

Suggestion Two

Sports Shirt Size *

Additional Comments

Payment Section

Payment Via *

Zelle
Credit Card

Quran Summer Camp 2026

Price: $1,272.00

Please Zelle the amount of $1272 to

finance@mahadalzahrausa.com

In the memo, include student first and last name - ITS - Summer Camp 2026
(e.g. Mohammed Ali - 30400000 - Summer Camp 2026)

Your spot in the summer camp will only be confirmed after full payment is received.

Zelle Transfer Screenshot

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Please upload a screenshot of the Zelle payment. It should clearly indicate the student name, ITS, and amount sent.

Stripe Credit Card *