Kalimah Programs' Event Registration Form
Child and Family Event Registration
The Arab-American Heritage Festival on April 27th is fully booked as of April 18th. Registrations for the waiting list will be accepted, but entry is not guaranteed.
https://bit.ly/AAHFest
Name of event and date
*
Participant's Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Applicants under 8 years old must be accompanied by an adult caregiver at events.
Participant's Gender
Female
Male
Parent's Name
First Name
Last Name
Phone Number
Email
*
Confirmation Email
Important event info may be sent by email, so please make sure it's a working email that you check frequently.
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Other Participants in the Same Family
Full Name (First Name Last Name)
Date of Birth (MM-DD-YYYY)
Gender (M/F)
Participant 2
Participant 3
Participant 4
Participant 5
Participant 6
Allergies, Special Needs, and/or Accommodation Requests
If any, please include an emergency contact other than the participant/parent.
Comments/Questions
Waiver and Photo Release Consent Signature
*
I UNDERSTAND THAT THERE ARE INHERENT DANGERS INVOLVED IN PARTICIPATION IN PROGRAM ACTIVITIES. I AM AWARE OF THE RISKS AND HAZARDS RELATED TO THESE ACTIVITIES. I UNDERSTAND THE RULES AND REGULATIONS FOR EACH ACTIVITY, AS EXPLAINED IN ANY WRITTEN OR EMAILED MATERIALS AND/OR EXPLAINED BY STAFF/VOLUNTEERS. I GIVE MY CHILD PERMISSION TO PARTICIPATE IN ALL KALIMAH ACITIVITES. I RELEASE, HOLD HARMLESS, AND INDEMNIFY KALIMAH AND ALL OF ITS STAFF, VOLUNTEERS, AND AFFILIATES FROM AND FOR ANY CLAIM, INJURY, OR OTHER LIABILITY OF ANY KIND WHICH IS CAUSED DIRECTLY BY PARTICIPANT, OR WHICH RESULTS FROM OR DURING MY CHILD'S PARTICIPATION IN THE PROGRAM. ON BEHALF OF THE CHILD/PARTICIPANT, I HEREBY CONSENT TO THE USE OF PHOTOGRAPHS, VIDEO FOOTAGE, AND CLASSWORK OF THE PARTICIPANT IN PUBLICATIONS, WEBSITE, AND OTHER MEDIA RELATED TO KALIMAH PROGRAMS.
Submit Application
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