[email protected]   +1 909-294-6553
  [email protected]
  +1 909-294-6553


 Home / Registration

Ansaar Academy Student Registration

This registration form has 4 pages. You must complete all sections by clicking Next at the end of each page. Click Submit on the last page to send your application.

Student Details

Applying For (select 1 or more) *

Student Details

If you are enrolling more than 1 students, please complete this form for each student.

Male Female
Parent Details

Parent/Guardian Information

Please complete this section entirely.

Mother Father Legal Guardian

Home Address *

Mother Father Legal Guardian
Emergency Contact
Agreement & Signature

Release of Liability and Assumption of Risk

Please read the following carefully before signing and submitting this form.

I will read the online booklet
I will pick up a copy from the office


This disclaimer outlines the enrollment acceptance policy of Ansaar Academy of Inland Empire referred to as "the school" hereafter for all its educational programs. By submitting an application for enrollment, all applicants and their guardians acknowledge and agree to the following terms and conditions:

  • Admission Criteria: Admission to any program at Ansaar Academy is subject to meeting Ansaar Academy's admission criteria, which include academic qualifications, character assessment, and other relevant factors deemed essential by the Ansaar Academy's administration.

  • Limited Enrollment: Ansaar Academy reserves the right to limit enrollment in its programs based on available resources, classroom capacity, and faculty-student ratios.

  • Academic Performance: Applicants may be evaluated based on their previous academic performance, extracurricular activities, and any additional assessments or tests deemed necessary by Ansaar Academy.

  • Character Assessment: Ansaar Academy places importance on character and conduct. Applicants' behavior, disciplinary records, and personal conduct will be taken into consideration during the evaluation process.

  • Application Process: Submission of an application does not guarantee acceptance. Ansaar Academy reserves the right to accept or deny admission to any applicant based on the evaluation of the application materials and other relevant information.

  • Admission Decision: Ansaar Academy's admission decisions are final and cannot be appealed. The reasons for denial of admission will not be disclosed.

  • Reservation of Rights: Ansaar Academy reserves the right to revoke an acceptance offer or dismiss a student from any program if it is discovered that the information provided during the application process is false or misleading.

  • Confidentiality: All application materials and related documents will be treated with strict confidentiality and used solely for the purpose of evaluating the applicant's eligibility for enrollment.

  • Enrollment Dates: Admitted students must adhere to the enrollment dates and procedures specified by Ansaar Academy. Failure to do so may result in forfeiture of the acceptance.

  • Program Availability: Ansaar Academy reserves the right to alter, suspend, or cancel any program based on unforeseen circumstances or insufficient enrollment.

  • Parent/Guardian Responsibility: Parents or guardians of accepted students are expected to comply with all rules, regulations, and policies of Ansaar Academy throughout the enrollment period.

By proceeding with the enrollment application process, all applicants and their guardians affirm that they have read, understood, and accepted the terms and conditions stated in this disclaimer. Ansaar Academy holds the right to amend this policy as necessary, and any such changes will be duly communicated to all parties concerned.


Review your entry

Please review your entry below. Click submit button to finish.

Applying For (select 1 or more)

Student Details

If you are enrolling more than 1 students, please complete this form for each student.

Full Name

Date of Birth


Does your child have any previous experience at another Islamic School? If so, what is the name of that school and how long did they attend ?

What is your child current grade level in school (K through 12)?

1st Parent Name

1st Parent/Guardian Role


1st Parent E-Mail

1st Parent Cell Phone

Home Address

2nd Parent Name

2nd Parent/Guardian Role


2nd Parent Cell Phone

Emergency Contact Person (if parents unavailable)

Emergency Contact Phone #

Please describe any food alergies we should be aware of, if any.

Please describe any medical or health conditions we should be aware of relating to your child, if any.

Does your child have any special needs or disability needs ? If yes, explain. If not say No

Release of Liability and Assumption of Risk

Please read the following carefully before signing and submitting this form.

I, on behalf of my minor child/children hereby waive in advance any and all actions or claims of injury or property damage which may occur as a result of my child/children participating in any activity or activities sponsored by Ansaar Academy. I hereby release and hold harmless the Inland Empire Community Wakf, the Islamic Center of Inland Empire, Ansaar Academy and the officials, employees, volunteers, and agents of these organizations.

I accept

I permit the taking of photographs of themselves and or minor children by the Islamic Center of Inland Empire and Ansaar Academy during the activities.

I accept

I permit off-site field activities when notified in advance.

I accept

I am aware that Parents are responsible for reading the school booklet.