Quran Registration Form

Quran Registration Form

    Midad's Programs Registration

    Student Information

    Course Preferences

    Parent's Information

    Media Release Agreement:

    I, the undersigned, agree as follows:

    1. I agree to have my child photographed, recorded and videotaped by Midad Al-Madina in connection
    with my participation in the Arabic Kids Program.

    2. I understand that my child may be recorded while participating in Arabic classes and events.

    3. I hereby irrevocably authorize Midad Al-Madina to copyright, publish, reproduce, exhibit,
    transmit, broadcast, televise, digitize, display, otherwise use, and permit others to use, (a) my
    child’s name, image, likeness, and voice, and (b) all photographs, recordings, videotapes,
    audiovisual materials, writings, statements, and quotations, whether in whole or in part, of my
    child, in any manner, form, or format whatsoever now or hereinafter created (collectively, the
    “Materials”), including on the Internet, and for any purpose, including, but not limited to,
    advertising or promotion of Midad Al-Madina Institute, its affiliates, or their services, without
    further consent from or payment to me.

    4. It is understood that all of the Materials and any derivative(s) thereof, such as films,
    audiotapes, videotapes, reproductions, media, plates, negatives, photocopies, and electronic and
    digital copies of the Materials, are the sole property of Midad Al-Madina Institute. I agree not
    to contest the rights or authority granted to Midad Al-Madina. I hereby forever release and
    discharge Midad Al-Madina, its directors, officers, employees, volunteers, licensees, agents,
    successors, and assigns from any and all claims, actions, damages, liabilities, costs, or demands
    whatsoever arising by reason of defamation, invasion of privacy, right of publicity, copyright
    infringement, or any other personal or property rights from or related to any use of the
    Materials. I understand that Al-Madina is under no obligation to use the Materials.

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