JPM Sengkang (Al-Mawaddah Mosque)

REGISTRATION FORM FOR YOUTH WING Registration No.

Date.
Please type or write CLEARLY. Your particulars are important to us in order to serve you well.

Join as or for : Member Programs, please specify _______________________________

Name:
Address:
Postal Code :
Phone: Hand Phone:
Email:
Nationality: Languages Spoken:

Parent/Guardian Particular
Name: E-mail:
Telephone:

*Contact details will be entered into our database.

Are you interested in joining our Executive Committee? Are you interested in joining any event planning?

As a youth volunteer you will also be asked to assist in some areas of your interest, please tick the appropriate boxes below to
indicate any skills or interests, you may tick more than one:

EVENTS INTEREST SKILLS

Camps Outdoors IT
Talks, forums & workshop Sports Designs/Artworks
Religious ceremonies Information Technology Oratory
Others, please specify Movies Language, specify ______________
_________________________ Games Others, please specify
Music / Instruments ______________________________
Traveling
Photography
Others, please specify
________________________________

LIABILITY RELEASE AND INDEMNITY

I hereby fully release and discharge the Almawaddah Mosque Youth Engagement Unit, including its Board of Management unconditionally from
any and all claims and liabilities whatsoever arising from my voluntary participation in any of the activities of the organisation, including any and
all incidental activities related to it. Accordingly I unconditionally convey risk of all actions, claims, costs, damages, expenses, judgments,
liabilities, suits and reasonable attorneys fees, arising out of my participation in any of the organisation's sponsored events, including but not
limited to any negligence or alleged negligence by the organisation or any service provider it retains. In reference hereto, I hereby
unconditionally waive and release any and all present or future claims of costs, damages, expenses, liabilities and suits against the Released
Parties, and I hereby agree to defend, indemnify and hold the Released Parties harmless from and against any and all such claims, costs,
damages, expenses, liabilities and suits, including all attorney’s fees, medical expenses, monetary damages and any other claims which may arise
as a consequence of my participation in the activities of the organisation.

Signature: Date:

Parent/ Guardian Signature*: Date:

*Parent or guardian's signature is needed for applicant below the age of 18.

Al-Mawaddah Mosque | Sengkang Central Post Office P.O Box 861 S 915408 | Email: info@almawaddah.mosque.org.sg/
Fax: 63840403