Release of Claim

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Release of Claim

I hereby release the Islamic Center of South Jersey and its Board of Trustees, the Executive
Committee, the School Board, other committees and office holders from all actions, damages,
claims, or demands which I, my heirs, executors, administrators, or assigns may have against the
Islamic Center of South Jersey and its Board of Trustees, the Executive Committee, the School Board, and other committees and officials for all personal injuries known or unknown which my
son or daughter has or may occur by his/her attending the school and or participating in any school
activities such as games, camps, field trips, picnics, indoor/outdoor activities etc.

I also give permission to ICSJ for my son or daughter to receive emergency medical treatment, if
required, as a result of injury or illness, which may occur during school activities.

ICSJ takes pictures of the children during competitions, and other school activities mentioned above. By signing below I am authorizing ICSJ to take and post the pictures on the website and/or masjid social media platforms.

By clicking Yes below, I (Parent/Guardian) give permissions and agrees to the above release of claim: *

Yes

Please type name of student *

Student-1 Full Name:

Please type name of student (if more than 1 student attending school)

Student-2 Full Name:

Please type name of student (if more than 2 students attending school)

Student-3 Full Name:

Please type name of Parents/Guardian signing this form *

Parent/Guardian Full Name:

E-mail

Emergency Contact Number (Cell Phone preferred) *

Submit

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