Youth Winter Camp 12/18

Join us for our Annual Youth Winter Camp!! We have amazing activities, hikes, and talks with our amazing sheikhs; Sh. Mohamad El Zahed, Tarik Ata, Mohammad Mana, and Zaid Khan lined up!! ❄️

Date: December 19th-21st

Ages: 14-24

Location: Wrightwood, CA

Early Bird tickets are $180 (until November 23), regular pricing is $200 (until December 7), and last-call tickets are $220 (until December 14).

Important Notes:

-If you sign up after November 30th, you won't be able to choose your hoodie size. A size large hoodie will be reserved for you.

-A 10% discount off your ENTIRE ORDER will be automatically applied if you sign up with your siblings!

Look out for an email with more details after registration. For questions or sibling discount inquiries, contact young@iioc.com.

Please note: NO refunds or additional discounts will be offered. Don’t miss out!

Name*

First NameLast Name

Date of Birth*

Date

Gender*

How many additional siblings are on this registration?*

Additional Siblings (Ages 14-24)

Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

E-mail*

example@example.com

Phone Number*

Camp Sweater Size(s)*

For siblings, please list name + size. Ex: Ameen Medium, Sarah Large, ...etc

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Email

example@example.com

Parent/Guardian 1 Information

Parent/Guardian Name*

First NameLast Name

Phone Number*

Email

example@example.com

Parent/Guardian 2 Information

Parent/Guardian Name

First NameLast Name

Phone Number

Email

example@example.com

Does the youth attendee have any medical conditions, chronic illness, or allergies that we should be aware of? If yes, please describe.

Do the additional attendees have any medical conditions, chronic illness, or allergies that we should be aware of? If yes, please describe.

Informed Consent and Acknowledgement I hereby give my approval for myself and/or my child's participation in any and all activities prepared by IIOC during the selected activity. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless IIOC and all its respective officers, agents, and representatives from any and all liability for injuries to myself and/or my child arising out of traveling to, participating in, or returning from the selected activity sessions. In case of injury to myself and/or my child, I hereby waive all claims against IIOC including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

I agree

Medical Release and Authorization I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of myself and/or my child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the my and/or my child's life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for myself and/or my child. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to IIOC and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of myself and/or my child.

I agree

Camp registration fee for all attendees | Payment page will appear once you submit*

Youth Camp Ticket Per PersonFor Siblings Registration: PLEASE UPDATE QUANTITY. 10% discount per sibling applied at checkout!

$180.00 Quantity

Enter coupon

Total

$0.00

Total

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature of the attendee or parent/guardian if attendee is under 18*

IIOC YOUTH WINTER CAMP ❄️

Parent/Guardian 1 Information

Parent/Guardian 2 Information