By submitting this form
you authorize ArabesQue Services , with business offices located in Seattle,
Washington, to draft on your next monthly bank statement. If my application
for enrollment The ArabesQ Islamic Academy. is accepted, I will comply
with all requirements regarding reports, fees, and instruction. I understand
that failure to do so will result in the cancellation of enrollment and
loss of credits. In addition, Arabesque Services. is hereby released from
any liability for accidents, injury, or fire which may occur at the home/satellite
school site.
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