PLEASE COMPLETE FORM AND SUBMIT TO REGISTER FOR RUJULAH 2019
    Parent/Guardian Information:
    Participant Information:
    Payment Information:
    FEE:
    $275* (Non-refundable)
    Due by Oct 9th, 2019
    Waiver:
    Terms & Conditions:

    1. I give my child(ren) permission to attend the Rujulah Retreat program from October 12th to October 14th 2019.

    2. I understand that participation in the activities that make up the Rujulah Retreat is not without some inherent risk or injury. As such, in consideration of my child(ren)'s participation at the Rujulah Retreat, I hereby release, waive, discharge, and covenant not to sue Risalah Foundation, its staff, organizers, Rujulah Retreat volunteers, organizers, participants, Mansfield Centre, their officers, volunteers, agents, or employees from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury that may be sustained by myself or my child. Whether caused by negligence of the releasees, or otherwise while participating in such activity, or while in, or upon the premises where the activity is being conducted.

    3. I give my permission for any emergency medical care or treatment to be performed on my child(ren) by a physician, surgeon, hospital, or medical care facility that may be required, including transportation, and accept responsibility for the cost. (This would only apply when a serious condition exists and camp staff and medical officials have been unable to contact you, the parent/guardian.)

    4. I hereby give consent for the photograph(s) of my child (children) to/be taken and or released for promotional purposes (in a manner congruent with Islamic values) by organizers of Rujulah Retreat.