mommy - MAS Youth Center of NJ

Parent Full Name

First

Last

Parent's Email Address

Parent's Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Child's Full Name

First

Last

Child's Age

Would you like to an additional child?

Would you like to add an additional child?

Consents & Agreements

I give permission for photography and videography to be taken during the event for promotional and archival purposes.

Parent's Signature

Clear Signature

Registration

Price: $20.00

Additional Children

Price: $5.00

Total

Item Quantity
Qty Total

There are no products selected.

Registration 1 $20.00

Additional Children 0 $0.00

Subtotal

Total $20.00

Stripe Credit Card

ABOUT US

The Muslim American Society (MAS) of Central New Jersey chapter is a non-profit organization that serves the needs of the Muslim community with an emphasis on children, youth and family programs promoting active community involvement. We are a chapter of the larger national organization Muslim American Society (MAS)

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