ICEL Youth Program Age 9-11 Enrollment
The Islamic Center of Greater Lansing is inviting youth ages 9-11 to enroll in the 2024 youth empowerment program. Our aims this year are:
1. to have fun
2. create strong and sustainable friendships
3. nurture Islamic good Islamic habits
4. and help the kids learn critical skills that they might not be able to learn in a traditional classroom. 

If you have a youth between 9-11 years old and are interested in having them participate in our program, please complete the form below and submit for one or more of our 3 sessions February-May, June-September, or October-January. Choose a session based on your availability and that of your child, but also be aware that your child will need to be in the specified age range during that session in order to participate. 

Age Restrictions:
*If your child is turning 12 within one of the sessions they will be eligible to join the girls or boys 12-18 group. 
*If your child is 8 and will not be returning 9 during the upcoming session they will still be eligible to participate in the youth 0-8 age group.

All parents who submit this form will be added to our email list and if they have it, will be added to our whatsapp group for this age group. If your child is too busy this semester to participate, please consider enrolling them for future sessions.
**If you have more than one child in this age group that you are enrolling, please complete 1 form for each child.
Email *
Youth age 9-11
Name of Parent/Guardian(s): First and Last Name *
Email address (we will be using this for communication) *
Phone Number (this will be used in case of an emergency and if you have it, whatsapp communication) *
Please provide an alternative contact in case of emergency if the above parent//guardian is not available? (name, relationship, and phone number) *
Name of child-if you have more than one child, please fill out 1 form for each child (First and last name) *
Age of child *
Date of birth (birthday) *
MM
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DD
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Gender of child *
Which session(s) will your child participate in? You may choose more than one but please only choose the session if your child meets the age requirements during those months. *
Required
Does your child require any accommodations for hearing, eyesight, mobility, or translation assistance? If so, please specify below, this information will be kept confidential, but we want to make sure we are serving your child's needs.  *
Does your child have any allergies or dietary restrictions that we should consider? Our programs will occasionally provide snacks. *
Does the Islamic Center and/or the group coordinator have permission to seek medical attention for the child in case of emergency? *
Does the Islamic Center, the Group Coordinator, and his/her support volunteers have consent to share the photos and videos of your child in the designated communication groups indicated above? *
Are there any other adults, not named above, who are authorized to pick your child from the program or events? (please include name-first and last-if yes) *
Is there any additional information or concerns that you wish to communicate? *
Please acknowledge the below liability disclaimer by checking yes (that you agree) or no (that you do not agree).  
I, the parent/legal guardian of the above-named child, hereby acknowledge that participation in the ISGL Youth Program may involve inherent risks, including but not limited to accidents, possible injuries, and illnesses. I understand and agree that the Islamic Society of Greater Lansing, its affiliate organizations, and its staff and volunteers are not liable for any harm, injury, or loss that may occur during the course of this program. I further release the Islamic Society of Greater Lansing, its affiliate organizations, and its staff and volunteers from any claims or demands arising out of such incidents. I confirm that my child is physically capable of participating in the program and has no known medical conditions that would jeopardize their safety. I have read and understood this agreement and voluntarily agree to its terms as well as all terms outlined in this form.
 *
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