Names of Allah – Girls Class (Session: 1 for ages 8–10)

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Names of Allah – Girls Class (Session: 1 for ages 8–10) (October)

Names of Allah – Girls Class

* Session: 1 (for ages 8–10)
* Time 2:00-2:30PM
* Weekly Saturdays
* Teacher Name Sr.Bushra

Parent Email Address ***Valid email address required***:

Parent Full Name:

Parent Phone #:

Emergency Contact Name:

Emergency Contact Phone #:

Address

Name of Child/ren Physician or Health Clinic

Address

Phone

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Child(ren) Information

Child Full Name	Date of Birth	Allergies	Attended last year class

I hereby release CVIC and its staff and agents from any and all liability, claims or damages.
I hereby waive any and all claims or actions on behalf of myself, my heirs, assigns or successors in interest with respect to CVIC and my child(ren) participation in the same.
I hereby give CVIC permission to photograph or videotape my child while in attendance at the event for the production of event materials/media for informational and other appropriate uses.
CVIC has the right to suspend or dismiss any child for violation of event policies and/or directives as deemed necessary by Event administration.
CVIC reserves the right to make changes in the program as necessary.

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