Please fill in the information below and we will contact you to get more details and answer questions in shaa Allah.

For more information 708-888-7121

Child information

Please be thorough and specific about your child. Failure to do that will give MAS QURAN Blossoms (“MAS Blossoms”) the right to expel the student and keep the all the fees. Students will be accepted on probation for six weeks before they are officially accepted. Throughout the six week period, students will be supervised and evaluated.

Health information is a very important. Please be sure to inform the teacher and the office staff of any specific health needs or information about your child. Enclose any relevant medical papers with this form to keep in the child’s folder. Quran Blossoms is not responsible for any medical problem that we were not informed about and was not confirmed in writing.

Medical Condition Information

Health information is very important. Please complete the following about your child’s health.  Reasonable steps will be taken to keep this information confidential, however, it will be shared with staff and employees or medical providers, as warranted.  

By signing the Medical Information and Consent Box:
1. I warrant all the information provided is true and correct to the best of my knowledge; and
2. I agree:
a. to assume all responsibility for the health of my child.
b. and understand it is my responsibility to update the Medical Information & Consent Form if there are any changes to my child’s health.
c. and give permission to transport my child to a hospital/clinic for emergency medical or surgical treatment and that the child’s medical history information can be provided to the health care provider.
d. and understanding any costs associated with the medical treatment of the child will be the responsibility of the child’s parent or guardian.

Parents information

Emergency Contacts

List names and phone numbers of three people other than the parents to be contacted in case of an emergency.  The emergency contacts will be contacted in a case where the parents cannot be reached or when the parents do not show up to take the child home on time.  The emergency contacts are allowed to take the students with them in case the parents cannot be reached. The emergency contacts may be asked to provide identification prior to releasing the student to same. 

If any day for any reason you or your emergency contacts are unable to pick up your child, please let the teachers and the office staff know in writing the date, name, phone number, and date of birth of the person who is taking the child home that day. The school staff has the right to ask the emergency person for a personal ID and make a copy of it. 

Agreements/ Terms

I understand and agree that I must keep registration and contact/pick up information up-to date by notifying office staff and teachers of any changes in writing. I understand and agree to my child being picked-up by the emergency contact persons or persons for which MAS QURAN Blossoms has been notified in writing.

By signing the Tuition Payment/Registration Agreement Box, I understand and agree to each of the following rules:
1. Payment for monthly tuition must be received within the first five calendar days of the month on days Blossoms has allotted for payment.
2. Registration fees are nonrefundable even if for any reason the child is unable to complete the year in the program.
3. Any parent who does not remit payment as per the set schedule will be called and sent a formal letter. If payment is not received immediately thereafter, the child will be removed from the program.
4. Registration fees and book fees are required prior to the beginning of the school year. Students cannot begin attending classes unless these fees are paid.
5. All parents are required to submit all required documents including medical paperwork during the registration period. Students will not be allowed to attend any program prior to submitting all the required paperwork. For students below the age of 18, medical documents must show that the students are up to date with all required immunizations.
6. All fees are non-transferable.

By checking the photography and Image Release Waiver box, I agree and give permission to MAS Blossoms to:
A. Photograph or videotape my child in any school activities,
B. Use photographs, digital, and videos in school presentations, lessons or activities, or
C. Release or publicize for informational or news-related purposes about MAS Blossoms or MAS Chicago.

I acknowledge that I have read and I agree to follow the registration rules and regulations.
I acknowledge that I have received a copy of the tuition rules and regulations for the 2023-2024 school year. I also acknowledge that I read and agree to pay the tuition on time.
I agree to pick up my child on time and to pay $10 for any time I pick up my child after the mentioned times stated in the terms above.

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