The Happy Shalom School (hereinafter called "HSS") operates Camp Gan Israel SF.
I declare that the applicant is my child / or the applicant is fully under my guardianship and care ("my child").
I have to the very best of my knowledge fully described the health history of my child.
My child has permission to engage in all prescribed camp activities and field trips except as noted.
I agree that I am responsible for keeping HSS fully informed of any changes in the health and emergency information.
I hereby permit the camp staff to administer my child’s routine medications as listed above.
In the case of an emergency (G-d forbid) where medical treatment is required (during camp or related to camp), I hereby declare that my child has the medical insurance to cover all of the costs and that I am otherwise fully responsible for all medical costs incurred and I will not hold HSS responsible at all.
If in an emergency HSS is unable to contact me or an authorised person, HSS and its agents have my authority to transport my child to the nearest hospital and to secure all necessary medical treatment for my child, including anaesthesia, X-rays, and any other medical treatment deemed necessary.
I hereby release and forever discharge HSS and its officers, trustees, employees, and staff members from all liability of any kind for any claim, demand, action, cause of action, damage, judgement, cost or expense that arises out of, or relates in any manner to my child’s attendance and participation in the activities involved and incidental to the Camp Gan Israel camp.
I am responsible for any loss, damage or destruction caused by my child to any property of Camp Gan Israel/Chabad of San Francisco/The Happy Shalom School or to any property for which HSS is liable for charges.
I hereby allow HSS to transport my child on HSS provided transportation.
I hereby declare that the information provided on this form is accurate and complete.