Registration Form - Shia Muslim Association of Bay Area

School of Ahlul’Bait
4423 FORTRAN CT, SAN JOSE, CA 95134, San Jose, Ca 95158
(408)946-5700 sab-admin@saba-igc.org http://www.saba-igc.org
Student Registration Form 2007-2008 (Hijri 1428-1429)
Instructions: Please complete all sections. Parent/guardian signature is required on the second page.
Father’s Name:
Mother’s Name:
Address:
City: State: Zip Code:
Parent’s Email Address:
Home Phone: ( ) Cell: ( ) Work: ( )
Emergency Contact Name and Phone Number:
Student Information (for one or more children):
1) Student First Name: Middle: Last:
Date of Birth: Month: Day: Year: Gender: Female: Male:
School grade for 2006-07: Pre-K KG 1 2 3 4 5 6 7 8 9 10 11 12
2) Student First Name: Middle: Last:
Date of Birth: Month: Day: Year: Gender: Female: Male:
School grade for 2006-07: Pre-K KG 1 2 3 4 5 6 7 8 9 10 11 12
3) Student First Name: Middle: Last:
Date of Birth: Month: Day: Year: Gender: Female: Male:
School grade for 2006-07: Pre-K KG 1 2 3 4 5 6 7 8 9 10 11 12
4) Student First Name: Middle: Last:
Date of Birth: Month: Day: Year: Gender: Female: Male:
School grade for 2006-07: Pre-K KG 1 2 3 4 5 6 7 8 9 10 11 12
5) Student First Name: Middle: Last:
Date of Birth: Month: Day: Year: Gender: Female: Male:
School grade for 2006-07: Pre-K KG 1 2 3 4 5 6 7 8 9 10 11 12
6) Student First Name: Middle: Last:
Date of Birth: Month: Day: Year: Gender: Female: Male:
School grade for 2006-07: Pre-K KG 1 2 3 4 5 6 7 8 9 10 11 12
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School of Ahlul’Bait
4423 FORTRAN CT, SAN JOSE, CA 95134, San Jose, Ca 95158
(408)946-5700 sab-admin@saba-igc.org http://www.saba-igc.org
Comments/Special needs:
National Origin: _____________________
(Optional, for statistical purposes only)
Please review the dress code, attendance, and other policies described in the SAB informational
brochure. In particular, please note the following:
Parents and family members who enter the SAB premises to drop off or pick up their children,
or to participate in SAB events, are also required to adhere to the MAB dress code.
Regular attendance and punctuality are required. The assembly preceding classes and salaat
following classes are both part of the weekly school session and barring exceptional cases,
students must attend this entire school session.
As parent/guardian of the student whose name appears above, I hereby release and waive any claim
against School of Ahlul’Bait, Shi’a Muslim Association of Bay Area (SABA), as well as SAB / SABA
officers, directors, agents, employees, and volunteers for any damage or injury suffered by the students
on account of or in connection with the student’s participation in school related activities. This Waiver
and Release of Liability shall operate as a complete waiver and release for any personal injury,
missing person, death, and waiver of property or other damage or loss, including loss of use, which
may arise in connection with the student’s participation in the school related activity. I acknowledge
that I am aware of the risks associated with the school related activities, whether the risks are by
reason of preparation for participation, transportation of the students, exposing the students to the
elements and to general public, or otherwise exposing the students to risks which may or may not be
generally associated with the school related activities.
I also agree to adhere to the dress code policy and other general policies of School of Ahlul’Bait as
described in the SAB informational brochure to the best of my abilities.
Parent/Guardian Signature: ____________________________
Date: ___________
Privacy Preferences:
SAB may in the future compile information about our students and parents into a SAB student
directory. Please indicate your privacy preferences:
Include our names and email address: Yes No
Include our phone number: Yes No
Include our address: Yes No
SAB may in the future compile a phone tree. As part of the phone tree, your phone number will be
given to another parent or a SAB volunteer who will call you to inform you about important
information related to SAB events.
Include my name and phone number as part of the phone tree: Yes No
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