YMC 2025 Registration Form

Traversing Through Time: Reflections to Realities

“Indeed, in their stories, there is a lesson for people of understanding” (12:111). Our history is a living testimony, filled with stories of faith, resilience, and triumph that guide us in navigating the present. These stories remind us of the challenges our Ummah has faced—how it persevered against adversity, upheld justice, and built a civilization rooted in the values of Islam.

As we reflect on this legacy, we are reminded of the unique responsibility we hold today. To be a Muslim is to embody the principles of enjoining what is right and forbidding what is wrong, while serving as an example for humanity. This responsibility extends beyond ourselves, calling us to unify our communities, contribute to the world, and ensure that our faith shapes the society we live in—not just within the masjid, but in every corner of our lives.

Surrounded by division and uncertainty, we look to the light of our collective identity to carry us forward. As we strive to uphold these responsibilities, we are reminded of Allah’s decree: “Indeed, Allah will never change the condition of a people until they change themselves” (13:11). The future of our Ummah rests in our hands—join us at our 30th annual Young Muslims Conference as we traverse through time, reflecting on the past and working towards a new reality.

Please enable JavaScript in your browser to complete this form.

Personal Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

Email *

Age *

Emergency Contact Information

Emergency Contact Name *

First

Last

What is the name of your Emergency Contact?

Emergency Contact Relation *

What is your emergency contact's relation to you?

Emergency Contact Phone *

What is your emergency contacts phone number?

Any medical conditions we should be aware of? (Type N/A if not applicable) *

Please list any allergies we should be aware of. (Type N/A if not applicable) *

ARE YOU YMC READY???? *YESYESYES - I am hassan or Karim

Please be HYPED

If you are under 18 and need regular medication, please list below. (Type N/A if not applicable) *

Waivers

Parent/Guardian Waiver Form (Participant Under 18 years old): I, the undersigned parent/guardian, of the above Participant understand and acknowledge that activities have risks and dangers, that may result in injury, and on behalf of myself, I hereby release and agree to hold harmless Young Muslims, its volunteers, administration, and directors, from all claims, actions, or losses related thereto. Young Muslims assumes no liability for injury, illness or damage arising from the results of participation of the above Participant. The Participant is urged to consult his physician concerning his health to participate. I, the undersigned parent/guardian for the above-named Participant hereby approve of my child’s participation in the Young Muslims Conference and consent to emergency medical treatment for my child on my behalf. *

• I accept the above and electronically sign this waiver

Waiver Form (Participant Over 18 years old): I, the Participant, understand and acknowledge that activities have risks and dangers, that may result in injury and/or illness, and on behalf of myself, I hereby release and agree to hold harmless Young Muslims, its volunteers, administration, and directors, from all claims, actions, or losses related thereto. Young Muslims assumes no liability for injury, illness, or damage arising from the results of participation of the above Participant. The Participant is urged to consult his physician concerning his health to participate. I, the undersigned Participant hereby approve of my participation in the Young Muslims Conference and consent to emergency medical treatment. *

• I accept the above and electronically sign this waiver

As parent/legal guardian or participant 18 years and older, I remain legally responsible for any personal actions taken by the above named participant. I agree on behalf of myself or my child named herein to hold harmless and defend Young Muslims (YM) and Islamic Circle of North America (ICNA) its president, coordinators, directors, volunteers, or representatives associated with the event from any and all actions, claims, demands, damages, costs, expenses, and all consequential damage arising from or in connection with my child attending the event or in connection with any illness (including COVID-19) or injury or cost of medical treatment in connection therewith, and I agree to compensate the organizations Young Muslims and/or Islamic Circle of North America, its president, coordinators, directors, volunteers, or representatives associated with the event for reasonable attorney’s fees and expenses arising therewith. By signing below, I agree that the participant named below is granted permission to attend the Young Muslims Conference parallel to the ICNA Convention taking place at the Baltimore Convention Center located at 1 West Pratt Street, Baltimore, MD 21201. I, (Parent/Guardian or Participant 18 years older), sign this consent form and liability waiver and confirm my agreement to these terms and others posted. *

• I accept the above and electronically sign this waiver

Liability Waiver: I hereby approve that if I am seen with, or have possession of, any vape, illegal drug, alcohol, weapons, or any other form of medically un-prescribed substance, whether in my belongings or luggage, that I will be immediately expelled from the conference (WITHOUT REFUND), will need to arrange transportation myself in leaving, and I will no longer be invited to any future YM Conferences. I understand that, if caught with any illegal substance, I will be reported to local authorities. *

• I accept the above and electronically sign this waiver

I hereby warrant that to the best of my knowledge, I (participant 18 years older) or my child is in good health, and I assume all responsibility for my (participant 18 years older) or my child's health. In the event of an emergency, I hereby give permission to transport myself (participant 18 years older) or my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. *

• I accept the above and electronically sign this waiver

Affiliation Information

Password *

Password given by coordinator or organization leadership.

Are you from: *

• New York
• None of the Above

Sub-Region *Select your SRGeorgiaCaliforniaChicagoDallasFloridaHoustonKentuckyPennsylvaniaNew Jersey NorthNew Jersey SouthNew York EastNew York WestConnecticutMassachusettsDMVOther, Expansion, Etc.

NeighborNet *

If you had selected the "Other" option, please list what expansion you are from *

What organization do you affiliate with? *

Gender *

• Male
• Female

Payment Info

Other Org Registration Cost *

Price: $50.00

1234567891011121314151617181920

Other Org Package (Select all that apply) *

• Bus - $60.00

Purchasing "Registration" is mandatory for entrance to the conference. Only choose ONE of the "Hotel" options

YM Package (Select all that apply) *

• Registration - $30.00
• Hotel (You are in a 6 person room) - $70.00
• Hotel (You are in a 4 person room) - $105.00

Purchasing "Registration" is mandatory for entrance to the conference. Only choose ONE of the "Hotel" options

NJ YM Package (Select all that apply) *

• Registration - $30.00
• Hotel (You are in a 6 person room) - $70.00
• Hotel (You are in a 4 person room) - $105.00
• NJ Bus (Only available for NJ regions) - $80.00

Purchasing "Registration" is mandatory for entrance to the conference. Only choose ONE of the "Hotel" options

NY YM Package (Select all that apply) *

• Registration - $30.00
• Hotel (You are in a 6 person room) - $70.00
• Hotel (You are in a 4 person room) - $105.00
• NY Bus (Only available for NY regions) - $55.00

Purchasing "Registration" is mandatory for entrance to the conference. Only choose ONE of the "Hotel" options

Financial Aid Code

Apply

If in need of financial assistance, please reach out to your coordinator or sub-regional coordinator.

Stripe Credit Card *

Total

$0.00

Would you like to volunteer for YMC on-site support? *

• Yes - Required for Financial Aid Recipients
• No

Would you like to volunteer for YMC marketing efforts? *

• Yes
• No

Phone

Submit