Itikaf Application - Islamic Center of East Brunswick

Personal Information

Name

First

Last

Email

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Start Date

I'tikaf Start Date

End Date

I'tikaf End Date

Emergency Information

Name

First

Last

Email

Phone

Health Information

Please specify any Medical Condition or Allergies. Enter NONE if no conditions

Medical Condition

Allergies

General Rules:

Itikaf is for men only
Minimum age requirement: 18 years
Participants are responsible for arranging their own Suhoor and Iftar
No food is allowed in the masjid area
No visitors are allowed in the Itikaf area
No group meetings or private study circles
Un-Islamic conduct or any form of misconduct will not be acceptable
Participants must keep the masjid area clean, including bathrooms and shower facilities
Respect all fellow participants, regardless of age
Only registered individuals will be allowed in the designated Itikaf area
Completion of a form does not guarantee placement – spaces are limited

Disclaimer: Islamic Center of East Brunswick (ICEB) shall not be held responsible for any injury, loss, expense or damage of any kind whatsoever suffered or incurred by any person who attends the I’tikaf program on our masjid at 402 New Brunswick Ave., East Brunswick, NJ 08816. By signing below, you agree to adhere to ICEB masjid policies and procedures, and will not hold ICEB Masjid and its entities liable for any suffering that may occur.

Declaration

I declare that the information above is true and I agree to the rules and regulations stated above.