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 Come join us for three amazing weeks of fun and learning! Camp Triple A: Awaken, Aspire, and Achieve will take place Mondays through Thursdays, 10 AM to 2 PM, from June 17th to July 4th, 2019 (childcare before and after available upon request). This year’s summer camp will be hosted by the Universal Academy of Pittsburgh (UAP) and the Islamic Center of Pittsburgh (ICP), with the first two weeks being at UAP and the final week being at the ICP. Camp Triple A will consist of Qur’anic studies, Islamic studies, and Arabic, along with field trips, art, and much more! $200 for the first child and $190 for every additional child. We hope to see you there, in shaa Allah!

Register your child for Camp Triple A today!
*Note: Filling out the form below will not complete the registration process. Tuition must be paid in full before the start of the summer camp to ensure your child’s participation in the program. ICP accepts cash or checks (payable to the Islamic Center of Pittsburgh).

Father's Information
Father's Information
Mother's Information
Mother's Information
Legal Guardian's Information
Legal Guardian's Information
Home Phone *
Home Phone
Cell Phone *
Cell Phone
Address *
Address
Emergency Contact Information *
Emergency Contact Information
Emergency Contact Phone Number *
Emergency Contact Phone Number
Child #1 Information *
Child #1 Information
Date of Birth *
Date of Birth
Child #2 Information
Child #2 Information
Date of Birth
Date of Birth
Child #3 Information
Child #3 Information
Date of Birth
Date of Birth
Child #4 Information
Child #4 Information
Date of Birth
Date of Birth
I am leaving my child/children with UAP/ICP's Camp Triple A program. I forever release and discharge UAP and the ICP, all of their employees, all of their agents, all of their members and managers, and the staff of this program for any liability that may occur during my child's visit/stay. I AGREE in consideration for my child's participation in all ICP services to the following: I AGREE to release the ICP from all claims for money damages. I AGREE to pay any losses, damages, or costs incurred and to hold the ICP harmless with respect to claims for harm to my child. I am a parent/guardian of a minor and I consent to the child's participation and AGREE to all of the provisions and AGREE to assume all of the obligations of this release on the child's behalf. I AGREE that the ICP as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers, staff and affiliated organizations. I further AGREE to be bound by all applicable ICP rules, terms and provisions of the organization.
I have given permission to the Islamic Center of Pittsburgh to take my child(ren) to all field trips. I am aware that sending my child(ren) on field trip days means that he/she/they will be going with the group to the field trip. I am also aware that if I do not want my child(ren) to go to any of the field trips, I will keep him/her/them at home.
I am aware that the ICP will be taking pictures/videos of children during the Camp Triple A program. The ICP will be using these photos to promote awareness of the program in presentations, flyers, brochures, and on the ICP website and social media platforms. Please indicate below whether you give permission to the ICP to photograph/videotape your child(ren).
Signature *
Signature
I verify as Allah as my witness that the above information is accurate and complete. I also have read and understood the release and waiver statement, field trips permission statement, and the photo release statement. By typing in your name in the below field, you e-sign your signature to all of the above information.
Date of Signature *
Date of Signature