I grant Congregation Shaarei Kodesh the right to take photographs of my child/children. I authorize Congregation Shaarei Kodesh to use and publish the same in print and/or electronically.

I agree that Congregation Shaarei Kodesh may use such photographs of my child/children with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

I hereby give permission for my child/children to participate in the 2018-2019 Chalutzim program at Congregation Shaarei Kodesh, on both Regional and Sub-Regional Levels. In the event of an emergency, surgical or otherwise, and I cannot be reached, I hereby give permission for my child/children to be transported to the nearest medical facility and specifically authorize the representative of Congregation Shaarei Kodesh to select a physician and/or authorize medical treatment, including hospitalization, anesthesia, injection or other measures which he/she feels are in the best interest of my son/daughter.

**I understand that this waiver that I sign will be the predominant permission slip for the year for my child/children unless another slip is required**