Program Registration ~ MOHID ©

Islamic Association of Collin County

6401 INDEPENDENCE PARKWAY, PLANO, Texas 75023, USA

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Registration Open

Youth Qiyam 3/6MIDDLE-HIGH SCHOOL

06
MAR

10:30 PM

07
MAR

2:00 AM

Program Fee:

One Time: $0.00

Offering Days: Friday

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Reserved Seats: 2/60

1 Contact Information

First Name *

Last Name *

Phone Number *

Email Address *

Address1 *

Address2

Country *

State *

City *

Zip Code *

Cell Number

2 Add Registrants

Primary Contact as First Registrant

Registrant Name*

Email Address

Age

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3 Payment

Monthly Recurring

Recurring Start Date*

Number of Months*

For Lifetime

Please note: You will incur a $1 charge if the recurring start date is not current date in order to verify the payment details provided. This charge will not be credited back to your account and you will receive a test transaction receipt for this amount.

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Since you purchased free Ticket No Payment Required.

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Name on Credit Card *

Credit Card Number*

Expiry Date*

CVV Code*

Bank Name

Name on Account *

Account Number*

Routing Number*

Account Type*

Consent * Do you give Islamic Association of Collin County consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Payment Summary

Program Fee

Total Registrants

Total Cost

Acknowledgement

By registering, you acknowledge that you will follow all the instructions provided to you by the Masjid for your and other community member's safety.
By registering, you acknowledge and agree that the event organizers, IACC Youth, and affiliated parties are released from any liability for injuries or damage.

Islamic Association of Collin County

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Youth Qiyam 3/6***MIDDLE-HIGH SCHOOL***

1 Contact Information

2 Add Registrants

3 Payment

Payment Methods

Or

Payment Summary

Acknowledgement

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Youth Qiyam 3/6MIDDLE-HIGH SCHOOL