Summer Soccer Program

ISB MAP and ITTIHAD FC Soccer Camp

Ages 6-16 on Mondays from 6:30 pm - 8:00pm between 11/18 - 12/9
Location: Troy Park Field 3

Participant's Name Participant's Name * First Last
Participant's D.O.B Participant's D.O.B * / MM / DD YYYY
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Participant's Email (Optional)
Participant's Phone (Optional) Participant's Phone (Optional) - ### - ### ####
Parent/Guardian Name Parent/Guardian Name * First Last
Parent/Guardian's Phone Parent/Guardian's Phone * - ### - ### ####
Parent/Guardian's Email *
Are you an ISB Member? *
Enter Coupon Code Below (Optional)
Waver & Liability Agreement
In the case of an emergency and I cannot be reached, I authorize the staff of the Muslim Athletic Program (MAP) and Islamic Society of Baltimore (ISB) to obtain whatever medical treatment he/she deems necessary for my child's welfare. I further understand I will be financially responsible for all charges and/or fees incurred in the rendering of said emergency treatment, regardless of whether or not my medical insurance would cover such charges and/or fees.

Waiver: In consideration of being permitted to participate in any way in the Muslim Athletic Program (MAP) and Islamic Society of Baltimore (ISB), I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue the Muslim Athletic Program (MAP) and Islamic Society of Baltimore (ISB), its officers, employees, and agents from liability from any and all claims including the negligence of Muslim Athletic Program (MAP) and Islamic Society of Baltimore (ISB), its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in the Muslim Athletic Program.

Assumption of Risks: Participation in Muslim Athletic Program carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from l) minor injuries such as scratches, bruises, and sprains to 2) major injuries such as eye injury, loss of sight, joint or back injuries, heart attack and concussions to 3) catastrophic injuries including paralysis and death.

I have read the previous paragraphs and I know, understand and adhere these and other risks that are inherent in the Muslim Athletic Program. I hereby assert that my or my kids participation is voluntary and I knowingly assume all such risks. *
Parent's Signature *

Draw or Type

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Full Name

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$0

Total

+Tax 3%

Summer Soccer Program

Summer Soccer Program

$0

Total

+Tax 3%

$`0`