MYNA Policies, Waivers, Release Forms and Guidelines

As a parent/guardian, I understand that participation in MYNA Camps, organized by Muslim Youth of North America (MYNA), involves a certain degree of risk. I have carefully considered the risk involved and have given my son/daughter my consent to participate in the MYNA Camp. I also agree to pay the MYNA CAMP registration fees. This health history is correct and complete as far as I know. The person(s) herein named have permission to engage in all MYNA CAMP activities except as noted. I allow MYNA to take pictures of my child and use them for all publicity related purposes. 

By submitting this form I give the permission to MYNA to provide, seek, and consent to routine health care, administration of prescribed medications (noted above), and emergency treatment for my child as may be necessary, including, but not limited to x-rays, routine tests and treatment, and/or hospitalization. I also give permission for the MYNA to arrange related transportation.

I agree to let me let me child participate in the above mentioned MYNA Event/Activity/Workshop/Program. I accept all responsibility for my child participating in this Event/Activity/Workshop/Program. I understand that MYNA will collect some information on my child for the activity and I give permission to MYNA to collect the information and use it for the Event/Activity/Workshop/Program.

I agree to the release of any records necessary for treatment, referral, billing or insurance purposes.

It is my intention that MYNA & ISNA be treated as acting in loco parentis if the person herein named is a minor. Further, it is my intention that the appropriate representatives of MYNA be treated as "personal representatives" for the purposes of disclosing protected health information pursuant to the privacy regulations promulgated pursuant to the Health Insurance Potability and Accountability Act of 1996. I hereby agree (pursuant to 45 CFR 164.510(b)) to the disclosure to MYNA representatives of the protected health information of the person herein described, as necessary: (i) to provide relevant information to the MYNA representatives related to the person's ability to participate in MYNA activities; and (ii) in the case of minors, to provide relevant information to the MYNA representatives to keep me informed of my child's health status.

In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by MYNA to secure and administer treatment, including hospitalization, for the person named above.

Virtual Campsite waiver & Code of Conduct

Above!

MYNA Transportation Waiver (Not Applicable)

For all campers, counselors, organizers, youth and adults, from here forward referred to as "participants", who will be getting to and from camp via Flights, Trains, or Busses, where such camper is in need of MYNA and its adults, counselors, advisors and staff, to provide transportation to and from airports, train stations and bus stations, MYNA and its adults, counselors, advisors and staff, will make every effort to pick up and/or drop off participants, in as best a timely manner as possible within the parameters of its abilites and resources.  However, MYNA will not be held responsible, financially or otherwise, for any participants missing flights, trains or busses.  This transportation is made possible through volunteers and tight schedules and MYNA can not guarantee situations beyond their control.   No parent or guardian of a participant or a participant themselves will hold MYNA responsible financially, or otherwise for any missed methods of transportation and delays in pick ups.  ISNA & MYNA assume no responsibility related to costs, sickness, injury, or death while campers are in transit during any of the above mentioned transports. 

MYNA Media Waiver & Consent

I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, all submission content or film likeness and recordings to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns.

 I understand that participation in the MYNA Camp, organized by Muslim Youth of North America, involves a certain degree of risk. I have carefully considered the risk involved and have given my son/daughter permission to participate in the MYNA Camp and I release MYNA/ISNA and all of its employees, officers, volunteers from any liablity that could result from my youth's participation in the MYNA Camp. 

MYNA Documentary Participation Waiver/Release Form (if you selected yes above to participating in the MYNA Documentary) 

I, the undersigned, hereby grant permission to the Muslim Youth of North America (MYNA), program of the Islamic Society of North America (ISNA), the Producer of The Documentary, following the lives of a few youth before camp, at camp, and after camp, to be later named, the right to use my full name, biography, video image, likeness, and audio collected during this production.

I also grant permission to record my image, voice, and performance, and transfer to the filmmaker/photographer all rights, title, and interest in the interview and video documentary. This includes, without limitation, the literary rights and the copyright of my picture, photograph, silhouette, other reproductions of my physical likeness and my voice collected in connection with the unlimited distribution, advertising, promotion, exhibition, and use throughout the world and in perpetuity and on whatever media is known or hereafter devised.

I agree that I will not assert, maintain or consent to others bringing any claim, action, suit or demand of any kind or nature whatsoever against the Producer including but not limited to, those grounded upon invasion of privacy, rights or publicity or other civil rights, or for any other reason in connection with the authorized use of my physical likeness and sound in The Documentary as herein provided.  I hereby release the Producer, its directors, officers, successors and assigns from and against any and all claims, liability, demands, actions, causes of action(s), costs, expenses and damages whatsoever, at law or in equity, known or unknown, anticipated or unanticipated, which I ever had, now have, or may, shall or hereafter have by reason, matter, cause or thing arising out of the rights granted to the Producer herein.

The Producer, in return, agrees to retain the integrity of the interviewee's image and voice, neither misrepresenting the interviewee's words nor taking them out of context. I attest that I have voluntarily agreed to be interviewed and that this document contains the entire and complete agreement concerning the use and preservation of my interview. 

I, the undersigned, shall not be given any fees for the services provided for this production.

MYNA Virtual Event Code of Conduct Waiver

MYNA is dedicated to providing a positive and harassment-free event experience for everyone. We do not tolerate harassment of event participants in any form, nor do we tolerate any behavior un-Islamic or that would reasonably lead to another event participant being made to feel unsafe. All communication, wardrobe, and background images should be appropriate for a professional audience including people of many different backgrounds.

Examples of encouraged behavior that contributes to a positive environment include:

• Using welcoming and inclusive language
• Being respectful of differing viewpoints and experiences
• Gracefully accepting constructive criticism
• Focusing on what is best for everyone at the event
• Showing empathy towards other participants

Unacceptable behavior includes:

• The use of bad language, or inappropriate gender interaction.
• Trolling, insulting or derogatory comments, personal or political attacks, or sustained disruption of talks or other events
• Deliberate intimidation, stalking, following, or harassing photography or recording
• Harassment of any kind, even in a joking or ironic manner
• Other conduct which could reasonably be considered inappropriate in a professional setting

Be kind to others. Do not insult or put down other attendees. Behave professionally. Remember that harassment and, racist, or exclusionary jokes are not appropriate at this event.

Each event guest is entirely responsible for their own actions.

Thank you for helping to make this a welcoming, friendly space for all.

BY SIGNING BELOW I CERTIFY THAT I HAVE READ THIS DOCUMENT AND FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.