Course Registration Form

MCS Winter Extracurricular Activities (January-February 2025)

Please complete one form per child.
Boy’s Soccer with coach DJ (Grades 1-5)
T, 3-4 pm in the soccer field (indoors during inclement weather)
Start date: 01/14-2/25
Cost: $100 (6 sessions)

Girls Yoga with Monica Pruitt Zoll (Ages 6-12)
Th, 3-4 pm in the Masjid
Start date: 01/16-2/27
Cost: $100 (6 sessions and a minimum of 8 students is required).

Taekwondo with Coach Ahmed (Grades 1-12)
W/F 3-4 pm in the Auditorium
Date: 1/15-2/28
Cost: $180 (14 sessions)
Student Name

First NameMiddle NameLast Name
Student Gender
Student grade
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail
example@example.com
Parent Mobile Number
Additional Phone Number
Are there any medical conditions/restrictions your child has that the coach should be aware of?

Payment*

Taekwondo (All Grades)W/F 3-4 pm in the Auditorium

$180.00

Boy’s Soccer with coach DJ (Grades 1-5)T, 3-4 pm in the soccer field (indoors during inclement weather)

$100.00

Girls Yoga with Monica Pruitt Zoll (Ages 6-12)Th, 3-4 pm in the Masjid

$100.00

Total

$0.00

Credit Card

Apple Pay

Google Pay

MCS Winter Extracurricular Activities (January-February 2025)