AL Noor Youth Group                                 Registration Form for Summer Camp: See the below flyer for detail. May Allah Subhanahuwatala put Baraka in this program, Ameen.
RELEASE OF LIABILITY FOR MINOR  
PARTICIPANTS
READ BEFORE SIGNING


IN CONSIDERATION OF ___________________________________, my child/ward,  being allowed to Name Of Minor Child/Ward participate in any way in the Islamic  Center of Southbay related events and activities. The undersigned acknowledges,  appreciates, and agrees that:
The risk of injury to my child from the activities involved in these programs is significant,  including the potential for permanent disability and death, and while particular rules,  equipment, and personal discipline may reduce this risk, the risk of serious injury does  exist; and,
1. FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME  ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my  child’s participation; and,
2. I willingly agree to comply with the program’s stated and customary terms and  conditions for participation. If I observe any unusual significant concern in my child’s  readiness for participation and/or in the program itself, I will remove my child from  the participation and bring such attention of the nearest official immediately; and,
3. I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal  representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS  Islamic Center of Southbay ; its directors, officers, officials, agents, employees,  volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if  applicable, owners and lessors of premises used to conduct the event  (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH,  or loss or damage to person or property incident to my child’s involvement or  participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE  OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
4. I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal  representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all  the above Releasees from any and all liabilities incident to my involvement or  participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE,  to the fullest extent permitted by law.
5. I, the parent/guardian, assert that I have explained to my child/ward: the risks of the  activity, his/her responsibilities for adhering to the rules and regulations, and that  my child/ward understands this agreement.
25816 Walnut St Lomita, California 90717 – www.masjidalnoor.org 

I, FOR MYSELF, MY SPOUSE, AND CHILD/WARD, HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
___________________________________ __________________________________ (PARENT/GUARDIAN SIGNATURE) (PRINT NAME)
Date Signed:___________________________________
UNDERSTANDING OF RISK
I understand the seriousness of the risks involved in participating in this program, my  personal responsibilities for adhering to rules and regulation, and accept them as a  participant.
___________________________________ __________________________________ (PARTICIPANT SIGNATURE) (PRINT NAME)
Date Signed:___________________________________
25816 Walnut St Lomita, California 90717 – www.masjidalnoor.org 

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UNDERSTANDING OF RISK: I understand the seriousness of the risks involved in participating in this program, my  personal responsibilities for adhering to rules and regulation, and accept them as a  participant BY CLICKING BELOW "YES". *
I, FOR MYSELF, MY SPOUSE, AND CHILD/WARD, HAVE READ THE ABOVE RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT BY CLICKING BELOW "YES". *
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