In consideration of Men of the Ummah allowing the Registrant to participate in the camp, I, the undersigned, do hereby release, forever discharge, and agree to hold harmless Men of the Ummah and its volunteers and collaborators from any and all liability, claims and/or demands for accidental personal injury, sickness, or death, as well as property damage and expenses of any nature whatsoever which may be incurred by the undersigned and/or the Registrant while involved in the activities and/or childcare. I, the Registrant (if Registrant is 18 or older) or the Parent/Legal Guardian of the Registrant (if Registrant is under 18), hereby grant my permission for the Registrant to participate fully in the camp activities including trips away from the designated campsite and center. Furthermore, I, the Registrant (if Registrant is 18 or older) or the Parent/Legal Guardian of the Registrant (if Registrant is under 18), hereby assume all risk of accidental personal injury, sickness, death, damage, and expense, as a result of the negligent, willful, or intentional, acts of said participant, including expenses incurred attendant thereto. If Registrant is under 18, Parent/Legal Guardian signature is required. Registrant (or Parent/Legal Guardian) signature:

I authorize an adult, in whose care the Registrant has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical, or dental diagnosis or treatment and hospital care, to be rendered to the Registrant under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned Registrant pursuant to this authorization. I give permission to Men of the Ummah to take whatever emergency measures are judged necessary for the care and protection of the Registrant while under their supervision. In case of a medical emergency, I understand that the Registrant will be transported to an appropriate medical facility by the local emergency unit for treatment if the local emergency team deems in necessary. It is understood that in some medical situations the Men of the Ummah staff will need to contact the local emergency resources before the Parent/Legal Guardian, the Emergency Contact, the Registrant's physician(s), and/or other adults responsible for the Registrant are notified. I understand that any expenses incurred will be borne by the Registrant and/or the Registrant's family. If Registrant is under 18, Parent/Legal Guardian signature is required. Registrant (or Parent/Legal Guardian) signature: