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EMERGENCY CONTACT and HEALTH INFORMATION
In the event the parent cannot be reached, the school will call the individual listed in Emergency Contact section.
The individuals mentioned in Emergency Contact should be able to:
- Give permission to administer health care;
- Pick up your child if your child is ill; or
- Give advice about caring for your child.
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CHILD 1 DETAILS
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CHILD 2 DETAILS
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CHILD 3 DETAILS
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CHILD 4 DETAILS
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CHILD 5 DETAILS
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FEES
Tuition must be paid in full at the time of enrollment.
Please send zelle to treasurer@dupeoria.org or make checks payable to Daarul Uloom Islamic School
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DAARUL ULOOM SUMMER CAMP CONSENT FORM
I, hereby agree to allow my child to participate in Daarul Uloom Summer Camp Program.
I understand and acknowledge that by allowing my child to participate in this activity,
I will be responsible for damage to property of the school and private parties caused by my child,
and for any injuries to my child or other parties, which may result from his/her participation in this activity.
The campers will walk or take public transportation to all camp events. I, hereby give permission for my child to
walk or ride public transportation with camp personnel.
I, give permission to Daarul Uloom Summer Camp directors to take my child for emergency treatment if necessary.
For good and valuable consideration, receipt, and sufficiency of which is acknowledged, I grant to Daarul Uloom, and to other such persons as the Daarul Uloom Camp may designate from time to time, the absolute right and permission to use in perpetuity my child’s name, image (on still and/or video footage), photograph, and any statement I may provide about the camp, either alone or accompanied by other material, in any manner, throughout the world, for the purpose of advertising, publicity, trade, or any other lawful purpose whatsoever, in any media now known or ever developed. Said statement may be reproduced and published in whole or in part and maybe modified and adapted in any manner to facilitate its use in advertising and/or publicity, so long as the general sense of the statement is not changed. I warrant and represent that all of the facts contained in said statement accurately reflect my opinions and experience. I agree that I will not hold Daarul Uloom Summer Camp or anyone who receives permission from them, responsible for any liability resulting from use of my name, image, or photograph and my statement in the manner described above
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