Assumption of Personal Responsibility::
I hereby assume all risks and dangers and will hold harmless The Simon Family Jewish Community Center and their respective offices, agencies, and employees from all actions, causes of actions, suits, and any claims, demands, and liabilities whatsoever, both in law and equity, in connection with participating activity. I have accepted responsibility for verifying that I have no physical or psychological problems that would prohibit my participation in this program. I agree to comply with all instructions and directions of the staff, including volunteer leaders, during my participation.
Permission to Provide Necessary
Treatment or Emergency Care:
In the event parent/guardian cannot be reached in an emergency and an individual age 17 or younger is in need of emergency care, I hereby give permission to the qualified personnel selected by the Agency to request treatment; to release any records necessary for insurance purposes; and to provide or arrange necessary related transportation for me/my child. In the event I cannot be reached or cannot respond in an emergency, I hereby give permission to administer treatment, including hospitalization, for the person named below.
Classes and events may be photographed for promotional purposes. Anyone wishing to be excluded should tell the photographer.