Youth Day Registration Form

Name*
First Last
Gender*
- Female
- Male
Email*
Phone*
Do you have any dietary restrictions?
Photo and Media Release*
I agree to the photo and media release policy.
I consent to photos and videos being taken of me at this event and I understand that they may be used by Hussain's Ark of Salvation and their partners.
Dress Code Policy*
I agree to the dress code policy.
I understand that Islamic dress code is mandatory for in-person attendance.
Youth Day Registration Fee - HARKS x JIY*
Price:
Credit Card
Card Details
Cardholder Name