Qirat Competition Presented by HHRD

Participant's First Name *

Participant's Last Name *

Parent/Guardian's First Name *

Parent/Guardian's Last Name *

Participant School: *

Participant Address: *

City: *

State: *

Zip: *

Phone: *

Email Address: *

Gender: MaleFemale *

Date of Birth * Invalid Format

Competition Age Group(automatically selected by DOB) *

GROUP 1 (2015-2013)

GROUP 2 (2009-2012)

GROUP 3 (2005-2008)

GROUP 4 (1996-2004)

How many people (including participant) will be attending? * Invalid Number

Support HHRD Campaigns (optional)

$50 Ramadan Food Package

$365 Orphan Sponsorship

$500 Wheelchairs

$600 Artificial Limb

Other

No, thank you I don’t want to donate at this time.

Payment Method: *

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