Al Huda Youth Registration

Al Huda Youth Program Registration

This form must be completed by a parent for each child registering for the Al Huda youth program.
Child's Name

First NameLast Name
Child's Age
Email
example@example.com
Parent's Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does your child have any allergies, medical conditions that we should be aware of? Please list/explain.
Emergency Contact Name:
Emergency Contact Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Please select session to enroll your child. You will be redirected to payment page after submitting this form.
Snacks Donation

To keep our youth energized, we’d like to stock snacks & drinks for this session. Parents can help by contributing. Would you like to donate?
If so, recommended donation is $20. You can also donate more as you like.
Waivers & Release: I hereby grant permission for my child to participate in the Al-Huda Youth Program. I understand that activities involve active games, outdoor activities, occasional off-site field trips, etc. I understand that my child’s participation in these activities, as well as those program-related activities not listed, may expose him/her to known danger as well as unanticipated risks. Acknowledging that such risks exist, I hereby waive, release, absolve, indemnify and agree to hold harmless Al-Huda Youth Group, Midwest Islamic Center, Masjid Al-Huda, Al-Huda Academy, Al-Huda Sunday School, respective mentors, officers, agents, volunteers, and employees from any and all claims of liability for personal injury or property damage my child may suffer while participating.
Photo/Video Release: I grant Al-Huda Youth Group permission use photographic images and/or video recorded during my child’s participation in Youth Program and/or related programs and activities for promotion, publicity, and/or commercial purposes (website, email, print, etc.). I understand that Al-Huda Youth Group may associate my child’s first name with the aforementioned materials, but will not associate my child’s last name without contacting me first.
Parents: Please use the link below to join the Whatsapp Group for communication: https://chat.whatsapp.com/HXwUOflPRVq5VdCoEu8UgY
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Al Huda Youth Program Registration