I attest that the above information is correct. I attest that I understand AUCC's policies and procedures. I attest that I and additional members of household are in good health and in the event of a medical emergency, I authorize AUCC to seek emergency medical care as deemed necessary by director. I attest that I will be photographed and/or recorded while at AUCC, which may be displayed via internet, newsletter, or advertisement. authorize AUCC's Masjid Al'Nuha to charge congregational dues at the beginning of every month as stated above. Cancellation Notice is required via email at a minimum of 30 days prior to charge. By signing this form, I hereby acknowledge and understand that AUCC as well as all other associated amenities such as Ray of Sunshine Foundation, staff, volunteers, affiliates, and board members, will not be held accountable in the case of illness, injury, death, and damage to personal property sustained to myself or any minors included on this form, while on the premise, located 55 Hillside Avenue, Teaneck, NJ.