I hereby voluntarily release from liability and waive any and all claims or causes of action for personal injury or death occurring to the student or others, or property damage arising from or relating to participation in the above activities, and whether arising from the negligence of Gan Camarillo Preschool or otherwise, against Gan Camarillo Preschool or any of its officers, agents, directors, teachers, or employees. I hereby release Gan Camarillo Preschool from liability for myself and my heirs, executors, administrators and assigns, and I shall indemnify and hold harmless Gan Camarillo Preschool from any and all such claims or causes of action, including attorney’s fees or damage to personal property. My signature on this form shall constitute an informed and knowing consent and waiver as required by law. I hereby acknowledge that I understand the effect of releasing Gan Camarillo Preschool of all such liability, including that caused by negligence.In case of an emergency, I give permission for my child to receive medical treatment.
I, the undersigned parent or guardian do hereby consent to any x-ray examination, anesthetic, medical or surgical diagnosis, or treatment and hospital service that may be rendered to said minor under the general or special treatment, and, hospital service that may be rendered to said minor under the general or special instructions, of our physician or other physician called in any emergency by the Gan Camarillo Director, the Rabbi, or responsible adult, in the event I/we cannot be reached, whether such diagnosis or treatment is rendered at the office of said physician or at a licensed hospital. It is understood that conscientious effort will be made to notify me or my spouse before such action is taken, but if this is not possible, the expense of this service will be accepted by me/us. It is understood that this consent is given in advance of any specific diagnosis or treatment being required. This consent shall remain effective until revoked. (By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.)
I give permission for my child/ren to be photographed and their photos to be placed in our advertisements, brochures, and websites. This includes but is not limited to: Chabadcamarillo.com, Gancamarillo.blogspot.com, the Gan Camarillo Facebook page and other social media platforms.
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