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Judaism through the Arts

Inspiring Jewish Pride and Identity in Jewish Children - the future of Judaism.

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Medical Form for all students

  • Contact Information

  • Medical and Developmental Form

  • If yes, please provide a current epi-pen and written permission to administer to JUDA at the beginning of the school year.

  • Medical Emergencies

    I authorize the director or director's designee to seek appropriate medical care for my child, if necessary.
  • A. In case of emergency, when neither parent can be reached, give names of two people who will take responsibility for your child:

  • Emergency Contact 1

  • Emergency Contact 2

  • B. If parents cannot be reached and emergency medical advice is needed, permission is given to the JUDA staff to phone my child's doctor:

  • C. In case of medical emergency requiring immediate emergency care, I authorize the paramedics to take my child to the nearest hospital if necessary. It is understood that I will hold Chabad of Scottsdale JUDA harmless for the nature and outcome of any emergency medical treatment. It is also understood that I leave the decision of what constitutes an emergency to the sole direction of the staff (please sign)

  • Should be Empty:
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