Event Registration

PLEASE READ CAREFULLY. This form is used for event reservations for all Midwest Islamic Center properties. All events require pre-approval of the completed form below from M.I.C. authorized personnel two weeks prior to the date of the event. No exceptions.
Please have the approval document with you at the time of the event for verification, if necessary.

Any use of downstairs facilities w/food $250
Any damages to property Full cost of repair or replacement

Renter is responsible for any and all damages. No Exceptions.

Event Date *

Name *

First

Last

Cell Number *

(000) 000-0000

Email *

Address *

Street, City, State, Zip

What kind of event will this be? *

Nikah, Seminar, Iftar, Halaqah, etc.

Event Start Time *

Setup Time *

Event End Time *

Will food be served? *

Please tell us about the food *

Where will you be catering from?

How many men will be attending? *

Estimate

How many ladies will be attending? *

Estimate

How many children will be attending? *

Estimate

Is this event a reoccurring event? *

If YES, please provide the details

Speaker Name (if applicable)

First

Last

Topics included in program

If applicable

Groom's Name

First

Last

ONLY FOR WEDDING EVENTS

Groom's Father's Name

First

Last

ONLY FOR WEDDING EVENTS

Bride's Name

First

Last

ONLY FOR WEDDING EVENTS

Bride's Father's Name

First

Last

ONLY FOR WEDDING EVENTS

Halaqah Event Leader

First

Last

ONLY FOR HALAQAH EVENTS

I agree to all the terms and conditions provided by Masjid Al Huda *

Registration form will NOT be processed without checking YES above

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