Middle School Girls Halaqa
Assalamu'alaikum wa rahmatullahi wa barakatuhu!

We are so excited to be offering this program for the MIDDLE SCHOOL girls in our community!

We will be holding this halaqa on the first Sunday of the month from 1:30 - 3:30 pm. What should you expect? Lots of hands on experiences accompanied by a halaqa and fun with friends.

This form is for ONE person only. Please fill it out for every individual child.

Please note: we will not be accepting anyone who IS NOT IN MIDDLE SCHOOL during the 2023 - 2024 school year. Stay tuned for more programs for other ages

We cant wait to see you!

Jazak Allahu khairun!
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Child first name *
Child last name *
Child's date of birth *
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Which grade will the student be in for the 2023 - 2024 school year? *
Allergies or Health conditions *
Parent/guardian name *
Parent/guardian email *
Parent/guardian phone *

Waiver: 


In consideration of the risk of injury while participating in this event, and as consideration for the right to participate in the activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the activity, and do hereby release and forever discharge the Islamic Association of Raleigh and the IAR Youth Committee, located at 808 Atwater Street, Raleigh, North Carolina 27607, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned activity, including traveling to and from an event related to this activity.


I am voluntarily participating in the aforementioned activity and I am participating in the activity entirely at my own risk. I am aware of the risks associated with traveling to and from as well as participating in this activity, which may include, but are not limited to, physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others' negligence, conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this activity, including travel to, from and during this activity.


I agree to indemnify and hold harmless the Islamic Association of Raleigh and the IAR Youth Committee against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If the Islamic Association of Raleigh or the IAR Youth Committee incur any of these types of expenses, I agree to reimburse the Islamic Association of Raleigh or the IAR Youth Committee.


I acknowledge that the Islamic Association of Raleigh and the IAR Youth Committee, and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of the Islamic Association of Raleigh and the IAR Youth Committee.


I acknowledge that this activity may involve a test of a person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of others, including but not limited to, participants, volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event.


I acknowledge that I have carefully read this "Waiver and Release" and fully understand that it is a Release of Liability. I expressly agree to release and discharge the Islamic Association of Raleigh and the IAR Youth Committee and all of their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against the Islamic Association of Raleigh and the IAR Youth Committee for personal injury or property damage.


To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of the Islamic Association of Raleigh and the IAR Youth Committee, and their agents and employees.


In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.


This agreement was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between the two parties of equal bargaining strength. The undersigned participant and the Islamic Association of Raleigh and the IAR Youth Committee agree that this agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.


In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.


Photo Release:


I, the under-named, parent / legal guardian of the above listed participant, hereby give my permission to the Islamic Association of Raleigh (IAR), their releases, and to their designated photographer(s) [i.e., counselors, program organizers, etc.], my free and unlimited consent to publish/broadcast, republish/rebroadcast or exhibit in the furtherance of their work, with or without the identification of me or my child by name, any photographs, videos, or audios of myself or my child, that have been obtained from my or my child's participation in any of the IAR's Youth Committee's Programs and Activities.  I furthermore waive any and all claims for any compensation by reason thereof or for damages for reasons thereof.


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To be signed by PARENT or Legal Guardian: After reading the waiver above and the statement below, sign your full legal name.                                       

I, the undersigned parent or legal guardian of the participant, affirm that I am of the age of 18 years or older, and that I am freely signing this agreement. I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a release of liability and a contract and that I am signing it of my own free will.
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