Parental Consent and Release For Participation in Muslim Youth Hackathon (MYH)

My child,   First Name*   Last Name* ,  * years of old,  wishes to participate in the Muslim Youth Hackathon (aka MY Hack) focused on AI Powered Dawa organized by Mafiq Foundation and hosted by ISNA on September 5-6, 2026 at the  Huntington Place Convention Center, 1 Washington Blvd, Detroit, MI.

I, the undersigned, am the parent or legal guardian of the above named child/youth and resides in   Street Address*City*State*Zip*    .

I understand that there is no guarantee that this activity is free of risk of personal injury or property damage or loss. I agree to abide by any applicable policies and rules issued in relation to the Event, and I understand that the My Hack committee reserves the right to end my participation at any time if I fail to do so, or for other good reason.

For any situation, I assure that I will be available for the phone call at  the number provided in this form. As a parent or legal guardian, I affirm that I have been completely informed all the activities that the child/youth will participate. I understand the general structure of the activities/programs and do not need to be informed of each and every activity.

I hereby voluntarily release, forever discharge the community, the corporation, its officers, directors, employees, volunteer and agents from any and all claims, demands, or causes of action, which are connected with my child's participation in the programs or the use of the equipment and facilities. I agree to pay for any and all medical expenses incurred and give permission to the doctor or health care professional to provide medical care if necessary. The information I've given in this form is complete and accurate.

I understand that photos, video and/or interviews of the Event may be recorded, and I hereby grant permission for Mafiq Foundation to use any of those containing my child’s name or image for publicity, promotion or news purposes.

By signing this form on      Date*  , I confirm that I have fully informed myself of the contents of this Parental Consent and Release Form by reading it before I signed it. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effect.   Signature*First Name*Last Name*