Page 1 of 2

Madina Masjid 11+ Saturday Social Registration Form

A short reminder, followed by games, good food and good company.

Form must be filled by someone 16+

Attendee details

Age

11+

Can the participant go home alone?

Yes

Emergency Contact Number

Attendee Address

Does the participant have any allergies?

Any medical conditions?

Madina Masjid aims to provide a safe and enjoyable environment for all attendees.

• This form must be completed by a parent/carer for participants • Parents/carers are responsible for drop-off and collection arrangements • Photos/videos may be taken for mosque use (e.g. social media) • Participants are expected to follow behaviour and safety guidelines • In case of emergency, medical treatment may be given if required.

By submitting this form, you agree to the above and give consent for participation.

Payment

We don't want cost to be a barrier to attending. If you require assistance with the entry fee, please contact us privately on +44 7466 432369, inshaAllah.