Register | Madinah Mentors

1. Personal 2. Emergency 3. Travel 4. Details 5. Payment

Personal Information

First Name

Last Name

Email Address

Phone Number

Date of Birth

Gender

Address & Emergency Contact

Home Address

Emergency Contact Name

Emergency Contact Phone

Background & Experience

Your answers are completely confidential and will never be shared with third parties. We ask these questions solely to understand your current level and tailor the programme to give you the best possible experience.

Quran Recitation Level

Quran Memorisation (Hifz)

Arabic Language Level

Daily Salah Consistency

Attended Islamic courses or retreats before?

Have you performed Umrah or Hajj?

Horse Riding Experience

What is your main goal for the 4 weeks?

If yes to Islamic courses — please briefly describe (optional)

Why do you want to join Madinah Mentors? (a few sentences)

Travel & Health

Nationality / Passport

Departure Airport

Flight Preference

Medical Conditions (optional)

Dietary Restrictions (optional)

No medical coverage is provided.

The programme fee does not include health or travel insurance. We strongly recommend arranging your own comprehensive cover before departure — this is your responsibility as a participant.

Payment Selection

Choose your payment plan

Choose a payment plan to see your deposit and balance breakdown.

How would you like to pay the non-refundable £250 deposit?

Select a deposit payment method to see the next step after submission.

I accept the terms and conditions.

Apply for Madinah Mentors 2026

Personal Information

Address & Emergency Contact

Background & Experience

Travel & Health

Payment Selection