Ramadan Elementary Children's Program

Program for children ages 6-10
Program will begin at Isha and be approximately 2 hours every night in Ramadan
Location will be at ISB main campus 2nd floor classrooms
Discover Ramadan's Joy: Learn, Play, Pray With Us!

How many children are you registering? *
First Child Name First Child Name * First Last
First Child Age *
Must be a number between 6 and 10
Second Child Name Second Child Name First Last
Second Child Age
Must be a number between 6 and 10
Third Child Name Third Child Name First Last
Third Child Age
Must be a number between 6 and 10
Please list any allergies for the children registering
Parent/Guardian Information
Parent/Guardian Name Parent/Guardian Name * First Last
Phone Number Phone Number * - ### - ### ####
Email Address *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Emergency Contact Information
Emergency Contact Name Emergency Contact Name * First Last
Emergency Contact Relationship *
Emergency Contact Phone Number Emergency Contact Phone Number * - ### - ### ####
Waiver
Waiver of Liability, Release, Assumption of Risk & Indemnity Agreement Notice:

This is a legally binding agreement. I understand that by signing this Childcare Waiver of Liability, I release and hold harmless the Islamic Society of Baltimore, and its owners, directors, officers, advisers, employees, agents, instructors, volunteers, childcare workers, and all other persons or entities acting for them from any and all claims, demands, suits, cost and charges, in connection with or arising out of the Islamic Society of Baltimore's childcare service, including but not limited to, personal injury, bodily harm, injury, or property damage occurring while the above child/children is/are in their care at the Islamic Society of Baltimore. I understand that if my child should become inconsolable during prayer, I am responsible to leave prayer and attend to my child. I will be responsible to feed my child and have my child use the restroom prior to start of class time to the best of my abilities. I understand I must remain in the Islamic Society of Baltimore at all times. I have read and understand the Islamic Society of Baltimore's Childcare Policy.

I also acknowledge and consent to the ISB Privacy Policies, including the Notice of Photographic and Media Recording, which may apply to any event held at, organized by, or hosted by the Islamic Society of Baltimore. *

Waiver of Liability, Release, Assumption of Risk & Indemnity Agreement Notice:

This is a legally binding agreement. I understand that by signing this Childcare Waiver of Liability, I release and hold harmless the Islamic Society of Baltimore, and its owners, directors, officers, advisers, employees, agents, instructors, volunteers, childcare workers, and all other persons or entities acting for them from any and all claims, demands, suits, cost and charges, in connection with or arising out of the Islamic Society of Baltimore's childcare service, including but not limited to, personal injury, bodily harm, injury, or property damage occurring while the above child/children is/are in their care at the Islamic Society of Baltimore. I understand that if my child should become inconsolable during prayer, I am responsible to leave prayer and attend to my child. I will be responsible to feed my child and have my child use the restroom prior to start of class time to the best of my abilities. I understand I must remain in the Islamic Society of Baltimore at all times. I have read and understand the Islamic Society of Baltimore's Childcare Policy.

I also acknowledge and consent to the ISB Privacy Policies, including the Notice of Photographic and Media Recording, which may apply to any event held at, organized by, or hosted by the Islamic Society of Baltimore. Check the box to agree to the terms above.
Coupon Code
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Total

Ramadan Elementary Children's Program

Ramadan Elementary Children's Program

Parent/Guardian Information

Emergency Contact Information

Waiver

$0

Total

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