Picnic-get together-field trip form – Ar-Rayyan Quran Academy

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Please enter all required information, sign and SUBMIT

Picnic/Get Together/Field Trip Permission & Liability Waiver Form
Dear Parent or Guardian,

Your child is going on a picnic/field trip/get together with parents & Ar-Rayyan family! Please read the information, then sign and SUBMIT.

Picnic/Field Trip/Get together Information:
Event Date:*
MM slash DD slash YYYY
Event Location:*
Event Time:*

: Hours

Minutes

AM/PM
Purpose:
- Picnic
- Get Together
- Field Trip
Permission & Liability Waiver Form
Cost:*
Cash or check payable to: AR-RAYYAN QURAN ACADEMY
Means of Transportation:*
- BUS/VAN (depending on the number of participants)
- Self-drive
- Drive with family
Leaves at:*

: Hours

Minutes

AM/PM
Arrive back:*

: Hours

Minutes

AM/PM
SPECIAL INSTRUCTIONS: Please be on time. Parents are solely responsible for their own safety, their family safety and the safety of their child/children at all times. Please be aware that Ar-Rayyan Quran Academy or its teachers and volunteers will not be responsible for your child. So, please ensure that your child is completely under your supervision to make this trip enjoyable.
Participant Name:*

has permission to attend a Picnic/Get Together/Field Trip.
*
I acknowledge that I will not seek to have the Ar-Rayyan Institute held liable in the event that any accident, injury, sickness, loss of property or any other circumstance or incident occurs during or as a result of my son’s/daughter’s/my participation in the picnic/field trip/get together/any ArRayyan Institute events. This release of liability includes any accident, injury, sickness, loss of property or any other circumstance or incident, or damages etc to the student, parent/s and their entire family as well as, to other individuals or property which may result from the student’s participation in the event. I hereby release and agree to hold harmless the Ar-Rayyan Institute, its officials, administrators, directors, agents, teachers, other parents, volunteers and employees, from any claims arising out of my son’s/daughter’s/my participation/my entire family’s participation in the ArRayyan Institute event(s). I take the FULL responsibility of myself, my child/children, my complete family and my belongings. I will also ensure that my child/children is/are under my supervision all the time.
Number of adults*
Number of Children*
Enclosed, please find Cash/Check/Zelle in the amount of*
to cover the cost of the trip.
I give my permission for*

to receive emergency medical treatment. In an emergency, please contact
Name of Child/Children/Parents attending event*
Name of Parent/Guardian*
Parent 1 phone*
Parent 2 phone*
Email*
Address*
Address City State Zip
Consent*
I agree to above content.
Signature of Parent/Guardian*
Date*
MM slash DD slash YYYY

Online Submission

Please enter all required information, sign and SUBMIT

Picnic/Get Together/Field Trip Permission & Liability Waiver Form

For Kids and Adults

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