TEST FORM - Al-Madrasah Al-Hanbaliyyah

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TEST FORMYaseen2023-08-26T08:28:56+00:00

Baarakallaah fiekum for registering. We will aim to get back to you within 48 hours inshaAllah. Also, please check your junk/spam folder.

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First name *

Last name

Adress *

City *

Country *

Email address *

Phone number *

Birth of Date *

In case of an emergency, please provide the name of a person we can contact. *

Emergency Contact Relationship *

Parent

Sibling

Spouse

Relative

Emergency Contact Phone Number *

Do you have any dietary restrictions or allergies we should be aware of?

Nut allergy

Vegetarian diet

Lactose intolerant

Gluten sensitive

Shellfish allergy

Vegan lifestyle

Soy allergy

Low sodium.

Diabetic needs

Where did you heard about our event? *

Have you taken a lesson before? *

Yes

Do you give consent for event organizers to take photos or videos of you during the event for promotional purposes? *

Yes

Payment *

Reserve your place by making a payment of €600 with the early bird gift offer before the end of October including a tailored Jubbah, cufflinks and leather bound course materials.

Make an initial payment of €300, followed by 3 subsequent monthly payments of €100.

Remarks/Question

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