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Jewish Enrichment Program

  • Student Information

    Please Fill Out One Form Per Child
  • Family Information

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  • Emergency Information

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    PARENTAL CONSENT: I hereby give consent for my child to participate in all activities of Chabad Jewish Enrichment Program (JEP) both on and off site, including trips, transportation to and from trips etc., unless I advise you otherwise in writing. MEDICALCARE:  In case of emergency, I hereby give permission to the physician selected by the school director, to hospitalize, to secure proper treatment for and to order injection, anesthesia, or other procedure deemed necessary for my child by an MD. Every effort will be made to contact the Parent / Legal Guardian and emergency contacts first. Should it be necessary for the wellbeing of the student to utilize outside medical or dental  services, all expenses involved will be paid for by the parent. To the best of my knowledge, my child is in good health and I will notify JEP if he/she is exposed to any infectious diseases. I understand that my child may be dismissed during a program, due to illness, at the discretion of JEP, and I agree to abide by the Director’s decision. IMAGES, ETC.: Permission is hereby given to use in promoting JEP and in other ventures directly relating to JEP(I) digital, photographic and video images or likenesses of student; audio of student; and (II) statements, articles, names, music, art, photographs, audio recordings, films and videos created by student or originating from JEP or from a JEP-related activity. INDEMNIFY & HOLD HARMLESS: I further release and agree to indemnify and hold harmless Chabad of Arlington & The Mid-Cities and its officers, servants or assigns from any liability or claim for any loss, injury, damage or expense resulting or arising from my child’s participation in JEP activities. I further agree that the use of any premises during the JEP program is made at the risk of the registrant.

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