Youth Brothers' Qiyam Registration Youth Brothers' Qiyam InstagramThis field is for validation purposes and should be left unchanged.Youth Brothers’ Qiyam 🌙 📖 🎮 A night filled with halaqas, FIFA, and Qiyam – all in the masjid with your brothers! 📅 Date: August 9th 🕰️ Time: From Isha to Fajr 📍 Location: Barrhaven Islamic Centre (3971 Greenbank Rd) 👥 For: Grd. 11/12 + University 📌 Registration requiredName(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Age(Required)Please enter a number from 15 to 25.Parent Name(Required) First Last Parent Email(Required) Enter Email Confirm Email Parent Phone(Required)Consent and Waiver AgreementPhoto & Video Consent(Required)I consent to the use of my image in any photographs or videos taken during Youth Brothers' Qiyam Night. These may be used in materials shared with attendees or for promotional purposes related to the Muslim Association of Canada (MAC), including on MAC’s website and social media platforms. I agree.Photo & Video Consent(Required)I give permission for images of my child(ren)/ward(s), taken during Youth Brothers' Qiyam Night, to be used in materials shared with attendees and for promotional purposes related to the Muslim Association of Canada (MAC), including the MAC website and social media platforms. I agree.Medical Authorization(Required)Should I require medical attention during the event, I authorize MAC event staff to use their best judgment in seeking appropriate care. I understand that I will be contacted as soon as possible in the event of illness or injury. I agree.Medical Authorization(Required)Should it become necessary for my child(ren)/ward(s) to receive medical care during the event, I authorize MAC staff to use their best judgment in arranging such care. I understand I will be contacted as soon as possible in the case of illness or emergency. I agree.Liability Waiver:(Required)I hereby waive, release, and discharge any and all claims for damages for personal injury or property damage arising from my participation in Youth Brothers' Qiyam Night. This release discharges the Muslim Association of Canada, its officers, staff, volunteers, and agents from any liability, including potential negligence. I acknowledge that the event may include recreational activities with inherent risks, and I voluntarily assume all such risks. This waiver is binding on my heirs and assigns. I agree.Liability Waiver:(Required)I hereby waive, release, and discharge any and all claims for damages for personal injury or property damage which may occur to my child(ren)/ward(s) as a result of participating in Youth Brothers' Qiyam Night. This includes releasing the Muslim Association of Canada, its staff, officers, volunteers, and agents from all liability, including potential negligence. I understand the event may involve physical or recreational activities with associated risks, and I voluntarily accept those risks on behalf of my child(ren)/ward(s). This waiver is binding on my heirs and assigns. I agree.Billing Address(Required) Street Address City Postal Code Youth Brothers' Qiyam Quantity(Required)12 items available. Price: $ 5.00 CAD Quantity Total Credit Card(Required)Card Details Cardholder Name
