2021 – Summer Camp

Parent's Full Name:

Parent's Email Address:

Parent's Cellphone Number:

Full Address:

Camper's Full Name:

Camper's Date of Birth:

Camper's Gender:
MaleFemale

Camper's Health Card Number:

Any medical conditions or allergies please specify:

If Camper is 12+ and are they vaccinated?
YesNo

Emergency Contact Name:

Emergency Contact Email Address:

Emergency Contact Number:

Relationship to Camper:

Do you need after camp care?
(Camp finishes at 4pm children must be picked up 4:15 there will be charge after 4:15)
YesNo

Media Release

I hereby grant MAC Al-Furqan Summer Camp to record, film, photograph, audiotape or videotape my/my child’s name, image, student work, and performance (hereinafter collectively referred to as “Works”) and to display, publish or distribute these Works for the purpose of publishing, posting on the Al-Furqan website, posting in schools, or social media as determined by Al-Furqan Summer Camp.

I Agree

MAC COVID-19 Waiver of Liability

I hereby acknowledge and agree to the following:

1. I understand the hazards of the COVID-19 and am familiar with the Federal, Provincial and Local guidelines (“Government Rules and Recommendations”) regarding COVID-19. I acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the Government Rules and Recommendations are regularly modified and updated and I accept full responsibility for familiarizing myself with the most recent updates.

2. Notwithstanding the risks associated with COVID-19, which I readily acknowledge, I hereby willingly choose for me and my children to participate in MAC Al-Furqan School.

3. I acknowledge and fully assume the risk of illness or death related to COVID-19 arising from my child being on the premises of MAC Al-Furqan School (whether that is through my child being exposed to COVID-19 and bringing the virus home, or whether my child picks it up while being transported to and from school). Accordingly, I hereby RELEASE, WAIVE AND DISCHARGE (on behalf of myself and my children) MAC, MAC Al-Furqan School, their owners, officers, directors, agents, employees and assigns (the “Releasees”) from any liability related to COVID-19 which might occur as a result of my and my child being on the premises and participating in the Activity.

4. I shall INDEMNIFY, DEFEND AND HOLD HARMLESS the Released from and against any and all claims, demands, claims, judgments, losses or expenses of any nature whatsoever (including, without limitation, lawyer’s fees, costs, HST and disbursements), arising from or out of, or relating to, directly or indirectly, the infection of COVID-19 or any other illness or injury.

I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability, understand it, have had or had the opportunity to obtain independent legal advice and sign it voluntarily of my own volition without any inducement from MAC and The School or any other third party.

Yes, I acknowledge.

Waiver Form

BY SIGNING THIS DOCUMENT, YOU WILL GIVE UP LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE MAC AL-FURQAN TORONTO IN EXCHANGE FOR MAC Al-Furqan Toronto allowing my child to participate in the summer camp and its related activities, I agree as follows:

1. I understand and accept the risks associated with the summer camp and other activities, including the possibility of physical or emotional injury, paralysis, death, and property damage. I understand that this agreement applies to all activities and games at the summer camp sessions. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.

2. Specific risks of the summer camp and other activities include: cuts and bruises, muscle and joint sprains and strains, broken bones, falling off of equipment, participants falling or landing on each other or any surface, double bouncing, flipping, slipping, and landing awkwardly. MAC Al-Furqan employees and volunteers have difficult jobs to perform. They seek to create a safe environment, but they are not perfect. They might be unaware of a participant’s health or abilities. They may give incomplete warnings or instructions. They cannot watch all participants at all times.

3. I VOLUNTARILY ACCEPT AND ASSUME ALL OF THE RISKS ASSOCIATED WITH THE SUMMER CAMP ACTIVITIES AT MAC AL-FURQAN AND I CHOOSE TO PARTICIPATE DESPITE THE RISKS.

4. If I am signing this Agreement on behalf of my child, I confirm that I have assessed the risks associated with Obstacle course activities, in light of the specific abilities and circumstances of my child, and I VOLUNTARILY ALLOW MY CHILD TO PARTICIPATE in MAC AL-FURQAN SUMMER course and related activities despite the risks. I therefore agree that if my child is injured during the MAC AL-FURQAN summer camp and related activities , I will accept all responsibility and liability for such injuries.

Please print Guardian name below: