Name *

First Name

Last Name

Age *

Please select one

Under 3 years old

4 to 6

7 to 9

10 to 12

Parent's Information *

First Name

Last Name

Birthday *

(So that Oasis can send you a gift on your birthday.)

MM

DD

YYYY

Phone *

(###)

###

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Would you like to volunteer to help out in future events ?

Yes

No

Are you interested in attending Islamic Studies classes? *

Yes, please let me know

Not right now

Address (optional)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country