HTBC Hijrah Club - Student Registration Form

Hijrah Club Program 2024/2025 Started on Saturday 09/07/2024

Payment Due on the 1st of Every Month
ADMISSIONS OPEN FOR THE ACADEMIC YEAR - 2024-2025

STUDENT REGISTRATION FORM
Students' Information*
Student's Mobile Number*
Is the student under 18?

YesNo
Parent's First NameParent's Last Name
Parent's Mobile Number*
Parent's Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
T-shirt size (price not included in tuition):*

SmallMediumLargeX-Large

Sports Activities Liability Waiver
I hereby affirm that I am voluntarily taking part in a course of instruction in physical fitness. I am voluntarily participating in the Activity entirely at my own risk.
In full consideration of the risk of injury while participating in the Activity, and for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily participate in 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, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any kind of risks related to traveling to and from as well as participating the Activity, which may include, but are not limited to, physical or phycological injury, pain, suffering, illness disfigurement, temporary or permanent disability, economic or emotional loss, and death.
I acknowledge that I have carefully read this form and fully understand that it is a release of liability. I expressly agree to release and discharge HTBC Hijrah Club and ICSGV from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action for personal injury or property damage.
Print Full Name (Parent's if under 18)
Today's Date

MonthDayYear
Date
Parent's Signature (if under 18)

Clear

Photo and Video Consent Form
I consent to have my/my child's pictures and videos taken during club lectures and activities by Hijrah Club and ICSGV. I understand that the pictures and videos may be used on different social media platforms for marketing purposes.
Print Full Name (Parent's if under 18)
Today's Date

MonthDayYear
Signature (Parent's if under 18)

Clear

Sensitive Topic Discussion Consent Form
I give my consent to Hijrah Club and ICSGV instructors to discuss topics sensitive in natures such as LGBTQ which will be discussed in an age appropriate manner.
Print Full Name (Parent's if under 18)
Today's Date

MonthDayYear
Signature (Parent's if under 18)

Clear

Allergies
Please list any known allergies including medicinal allergies.*

Club Rules
1. Age of club members is between 14 and 19.
2. No parents or family members are allowed in sessions whatsoever, except the members of such club.
3. Members of club must adhere to modest clothing according to islamic principles.
4. All activities, discussion, and overall content are private and exclusive to the club members only, and within the club they are private to each gender's group.
5. Boys and Girls must be segregated and have their own respected sessions.
6. Members of club must wear club apparel when attending if purchased.
7. Respect others including club members, staff, and visitors.
8. Be punctual for sessions.
9. Most importantly, make new friends and have fun!
I have read, understand, and agree to abide by the above rules and regulations.
NOTE: You will be redirected to the payment page after submitting the form.
Should be Empty:

Hijrah Club Program 2024/2025 Started on Saturday 09/07/2024

ADMISSIONS OPEN FOR THE ACADEMIC YEAR - 2024-2025

Sports Activities Liability Waiver

Photo and Video Consent Form

Sensitive Topic Discussion Consent Form

Allergies

Club Rules