Northeast Global Ismaili CIVIC Day - Washington, D.C.
Join us in a global day of service on National Public Lands Day by participating in beautification activities aimed at realizing our responsibility of caring for the natural environment!

Saturday, September 24th, 9-11am at Belle Haven Park
Alexandria, VA --- GPS link to meeting spot 

All participants will receive a coupon for free admission to any National Park!

Please wear long pants & closed toe shoes that can get dirty / muddy.

Parking is free & rides can be arranged!

Parking instructions: Turn left into the park & park in either lot. Do not park in the marina area.

For more information, please contact: Zenobia Merchant or Shafeen Hemnani (NE AKYSB members)
zenobiamerchant@gwu.edu 
shafeen.hemnani@gmail.com

NOTE: All members who wish to participate must complete a separate registration form. Parents may complete forms for minors.
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First Name *
Last Name *
Date of Birth *
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Gender *
Email Address *
Phone Number *
Are you open to receiving text messages about this event?  *
Zip Code *
Jamatkhana *
If you would like to purchase an Ismaili CIVIC t-shirt for $6, please indicate your preferred size.
Please note: 2022 t-shirts are the same color & design as 2021. 
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Would you like your service to be applied towards your Time and Knowledge Nazrana (TKN)? 
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Waiver & Release Form (to be completed by participant OR parent/guardian of participant if participant is a minor/17 years or younger)
VOLUNTEER WAIVER & RELEASE AGREEMENT (“this Agreement”)

“Indemnitees” shall mean the Organizations (as defined below), as well the officers, members, staff, volunteers, affiliates, and agents of one or more of the Organizations (as defined below), including but not limited to one or more Organizations’ decision-makers, organizers, counselors and staff associated with the Voluntary Service.

“Organizations” shall mean the institutions of the Ismaili community and shall include, but not be limited to, His Highness Prince Aga Khan Shia Imami Ismaili Councils for any respective national, regional, or local jurisdiction, and the Aga Khan Youth & Sports Boards for any respective national, region, or local jurisdiction.

“Voluntary Service” shall mean participation as a volunteer who is provided by, or whose participation has been partially or entirely arranged by, one or more of the Organizations, for voluntary service at or in connection with the activity for which you are currently registering through the theismailiusa.org portal, regardless of whether or not the activity, or any site(s) at which the activity will occur, is operated in part or entirely by one or more of the Organizations or by any business(es), municipality(-ies), government agency(-ies), quasi-government agency(-ies), other organization(s), and/or otherwise.

In exchange for being given the opportunity to engage in the Voluntary Service, you, the undersigned Volunteer, hereby agree to RELEASE, INDEMNIFY, and HOLD HARMLESS each of the Indemnitees from and against any and all losses, claims, damages, causes of action, liabilities, costs, and expenses which may be asserted against one or more of the Indemnitees, of every nature whatsoever, known or unknown, WHETHER BASED IN PART OR IN WHOLE ON ONE OR MORE INDEMNITEES’ SOLE OR CONTRIBUTORY NEGLIGENCE OR OTHERWISE (INCLUDING, BUT NOT LIMITED TO, ONE OR MORE INDEMNITEES’ NEGLIGENCE THAT CAUSES INJURY OR DAMAGE JOINTLY AND/OR CONCURRENTLY WITH YOUR NEGLIGENCE, WITH THE NEGLIGENCE OF ONE OR MORE OTHER INDEMNITEES, OR WITH THE NEGLIGENCE OF ANY OTHER PERSON OR ENTITY WHATSOEVER), arising out of or connected with (1) any damage to your person or property, or any injury or death to you, as a result of your or someone else’s engagement in, or as a result of any act or omission by you or someone else in, the Voluntary Service; (2) any damage to anyone else’s person or property, or any injury or death to anyone else, as a result of your engagement in, or as a result of any act or omission by you in, the Voluntary Service; (3) any damage to your person or property, or any injury or death to you, as a result of your or someone else’s engagement in, or as a result of any act or omission by you or someone else in, any travel to, from, or otherwise related to the Voluntary Service; (4) any damage to anyone else’s person or property, or any injury or death to anyone else, as a result of your engagement in, or as a result of any act or omission by you in, any travel to, from, or otherwise related to the Voluntary Service; or (5) any policy, procedure, conduct, act, or omission of one or more of the Indemnitees.

You voluntarily and knowingly assume any and all risks for your participation in the Voluntary Service and hereby consent to any reasonable medical or surgical treatment which you may need and which arises in connection with the Voluntary Service; provided, however, nothing contained herein shall be deemed an obligation by any of the Indemnitees to provide any such medical or surgical treatment. You understand and accept that the cost of all medical and surgical treatment shall be paid by you.

You agree that any controversy or claim arising out of or relating to this Agreement shall first be submitted for mediation prior to the filing of a lawsuit or initiation of any legal proceeding.

You hereby agree that this Agreement also shall be binding on behalf of your heirs, successors, assigns, and any other persons or entities claiming through or under any of them.

The provisions (whether in the form of consents, authorizations, releases, agreements, or otherwise) of this Agreement should be construed to the greatest extent allowed by law. In the event that any of the provisions of this Agreement, or the application hereof to any individual or circumstance, is held by a court of competent jurisdiction to be invalid, illegal, or unenforceable in any respect under present or future laws, this Agreement shall be fully severable from the invalid, illegal, or unenforceable provisions and this Agreement shall then be construed and enforced as if the invalid, illegal, or unenforceable provisions had not been contained in this Agreement; and in such event, the remaining provisions of this Agreement shall remain in full force and effect and shall not be affected by the illegal, invalid, or unenforceable provisions or by their severance from this Agreement. Furthermore, in lieu of any illegal, invalid, or unenforceable provisions, there shall be added automatically as part of this Agreement provisions that are legal, valid, and enforceable but as similar in terms to such illegal, invalid, or unenforceable provisions as may be possible.
By selecting "I Agree", you are signing this Agreement electronically and you are agreeing as follows:
1. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement;
2. By selecting "I Agree" using any device, means, or action, you consent to the legally binding terms and conditions of this Agreement;
3. You agree that the signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed this document in writing; and
4. You also agree that no certification authority or other third-party verification is necessary to validate your E-Signature, and that the lack of such certification or third-party verification will not in any way affect the enforceability of your E-Signature. *
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Full Legal Name of Participant or Parent/Guardian (this serves as your electronic signature)  *
Date Signed (today's date) *
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Transportation: Do you need a ride to the venue? 
Are you able to offer rides to other Jamati members?
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