Religious School Registration Form: 2017-18

PARENTS: PLEASE NOTE:
Please describe any specific learning or behavior challenges that your student(s) may have. Does your child(ren) have an IEP? Does your child have a specific allergy or medical condition that we need to know about? It is important that you share this information so we can provide the very best experience for your child in Religious School. We would love the opportunity to discuss this with you before school starts.

Medical: In the event of a medical emergency, I authorize the staff to administer first aid and/or obtain emergency medical treatment for my child. I understand that an attempt will be made to contact me immediately. If injury is serious and parents cannot be contacted, my child will be brought by ambulance to the nearest hospital. Costs of the medical attention and ambulance are the responsibility of parent/guardian.

Field Trip Authorization I hereby authorize my child to go on field trips scheduled by the Religious school in conjunction with the programs for which my child is registered. Temple Israel Religious School may transport my child on field trips by whatever means it deems appropriate. The undersigned hereby releases and forever discharges Temple Israel, its agents, designees, and employees from any and all claims, actions, or causes of actions resulting from sickness or accidental injury. It is clearly understood that no smoking, alcohol, or drugs other than those prescribed by a licensed physician will be permitted on any trip. It is also understood that in the event of behavior unacceptable to the staff, parents will be notified and the child will be sent home at the parents’ expense.

Emergency Authorization It is understood and agreed that Temple Israel, its agents, and employees shall not be liable for any claims, actions, or causes of action arising out of any conduct authorized here, and the undersigned hereby specifically releases Temple Israel and its agents, designees, and employees from any and all such claims, actions, or causes of action.

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