ICBYG January 2011 Qiyam Program Permission Slip

This permission slip is for my son/daughter to participate in the Wayland Youth Group’s Qiyam
al Layl event. I understand that if my son/daughter fails to adhere to the rules and guidelines
provided by the Youth Group chaperones, I will be contacted to pick up my son/daughter from
the masjid.

Pick up will be between 9am and 10am on the morning of January 30th, 2011. (Sunday School
begins at 10am, please make sure your child has been picked up before 10am if s/he is not
attending Sunday School).

If your son/daughter would like a sleeping bag/blanket & pillow for sleeping, please remember
to bring those. If s/he would like to bring a change of clothes, remember to pack them and any
toiletries. (Any bedding should be picked up before Sunday School begins to ensure enough
space in the classrooms)

Thank you & Jazaak-Allahu Khairan,

_ _ _ _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __

Please return this bottom portion to the YG- chaperones.

I have read and agree to send my child to participate in this event.

I ___________________________ give permission for my son/daughter,

____________________________, to attend the ICB Wayland Youth Group Qiyam-ul-Layl

event.

Emergency Contact:

Name:_________________________________Relation:_______________________

Cell Phone Number: _________________________