MCWS LIABILITY/CONSENT WAVIER FORM
Muslim Community of Western Suburbs
40440 Palmer Rd, Canton, MI 48188
Event/Activity: MCWS High School Summer Camp (Aug 15th-17th, 2025)
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I, the undersigned parent or legal guardian, acknowledge that my child is voluntarily participating in activities organized by the Muslim Community of Western Suburbs (MCWS) and/or Medina Activity Center (MAC), that involves inherent risks, including, but not limited to physical injury, illness, or property damage.
I hereby RELEASE, WAIVE, DISCHARGE, and agree NOT TO SUE MCWS or MAC, and its board members, trustees, officers, volunteers, employees, and affiliates (collectively referred to as "RELEASEES") from any and all claims, liabilities, demands, actions, or causes of action arising out of any injury, loss, or damage—including serious injury or death—that may occur to my child while participating in these activities or while on the premises where they are conducted.
I understand and agree that this waiver extends to any injuries or damages that may result from the ordinary negligence of MCWS, MAC and its representatives. I also agree that this release and waiver applies to me, my child, and our heirs, assigns, and personal representatives.
Further, I give MCWS/MAC permission to take and use photos/videos of my child for promotional purposes.
By signing below, I acknowledge that I have read and understood this Liability Waiver and Hold Harmless Agreement. I am signing it voluntarily and with full knowledge of its implications.
Medical Release and Authorization
As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
Release authorized on the dates and/or duration of the registered season.
This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.