Masjid Noor Summer School Registration
July 23rd thru August 31st, 2018
Tuition for camp is $50/student payable at the start of the camp.
Student Name *
Your answer
Gender *
Age *
Your answer
Grade entering in School *
Parent/Guardian Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Email address *
Your answer
Payment options ($50/child) *
Waiver - The responsible party must read the entire contract before signing. I do hereby agree to participate in the Summer School Program at Masjid Noor Inc.(MNI). My child is voluntarily participating in these activities. I hereby waive and release any claim or rights to sue Masjid Noor Inc., it’s agents, officers, students, instructors, employees, volunteers and management as well as premises from any and all injuries that may occur on or off these premises through negligence or not, while participating, practicing, watching or competing in any event or program. MNI assumes no responsibility for loss of, or damage to, any personal property belonging to student or guest while on the premises.I understand that while in any events or programs, my child may be engaging in activities and that these activates may have risks and hazards inherent to the type of activity or use of certain equipment or the facilities themselves. As we are aware, young children are prone to mishaps. Although we will give every effort to have adequate supervision, occasionally accidents can happen. In the instance that an emergency arises we would use this form as your specific permission to transport and have your child treated by a professional caregiver/physician, etc.In signing this consent form, I hereby acknowledge and represent that I have read the foregoing, understand its terms, and sign it voluntarily. I also acknowledge that my child/children is in excellent physical health and is able to endure recreational activates and play, including the above named activities and others not mentioned or stated.I have read and agree with all the above. I agree to waive any and all claims against persons connected with Masjid Noor Inc.. *
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