ICP School

1Camper and Parent Information

Camper full name

Parent/Guardian name

Phone / Email

2Consent Selection

YES. I give permission for ICP Summer Camp and Islamic Center of Peoria to photograph, record, or otherwise capture my child during camp activities. I authorize ICP to use these images, video, audio, or digital media for camp memories, printed materials, newsletters, website posts, social media posts, internal presentations, and community promotional purposes. I understand my child may not be individually named unless I provide separate written permission.

LIMITED CONSENT. I give permission for group photos/videos only, but I do not permit individual close-up photos, interviews, or use of my child’s name.

NO. I do not give permission for ICP Summer Camp or Islamic Center of Peoria to use photos, video, audio, or digital media of my child for public or promotional purposes. I understand ICP will make reasonable efforts to honor this request, though my child may appear incidentally in crowd or background images from public/group events.

3Release and Understanding

I understand that media may be shared online and may be viewable by the public.
I understand that ICP will not sell my child’s image or media to third parties.
I understand that this consent remains in effect for the current summer camp season unless I revoke it in writing.
I release ICP, its board, staff, volunteers, and representatives from claims related to approved media use within the scope of this consent.

4Signature

Parent/Guardian signature typed name

Date

Printed name

ICP Summer Camp Registration Form

Parent / Guardian Media Consent Form