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2023-24 Religious School Part Two - Medical and Emergency Info

This form is required of all students.
Safety is our first priority.

Parent or Caregiver Information

List Child(ren) or Teen(s) Enrolling in Programs

Important Emergency Information 

Family Member Emergency Contact:

Non - Family Emergency Contact:

Medical Information

Release of Liability:

By checking yes, under the terms of this Agreement, the Releasor hereby releases, acquits and discharges any and all claims arising from or related to their entry and participation in the legal relationship resulting from the parent/guardian and child/ren with Congregation Nevei Kodesh - including, but not limited to, all obligations, pecuniary loss and intangible damages, the types of claims for personal injury, property damage or any other Claims arising from or related to the undersigned's entry into and participation in the activities. 

The Releasor understands this release shall not constitute as an admission of guilt or any wrongful act with respect to Releasor, neither does this admit any liability which the Releasor may cleaim as of right against the Release.

Should a complaint be filed in any competent court by the Releasor in connection to this release, the Releasor voluntarily withdraws, revokes, desists, in pursuing the complaint against Release. 

This Release inures the benefit of the heirs, successors, assigns, and representatives of parties. This Agreement and its validity, and any claim, controversy or dispute arising under or related to this Agreement shall be governed by and construed in accordance with the laws of the State of Colorado.

Both parties represent that they have read and fully understand the contents of this Agreement and they have freely and voluntarily subscribe to this Release Agreement. 

Medical Release

By checking the box below I give my permission for my child/ren or teen/s to receive emergency medical transportation and treatment if it becomes necessary and neither the family nor other emergency contact can be reached.       

Field Trip Release

By checking the box below I give my permission for my child/ren or teen/s to attend field trips during school hours with trained Nevei Kodesh staff. I understand that I will receive notice of fieldtrip travel prior to my child or teen attending. 

Photo Release

By checking the box below I give my permission for my child/ren or teen/s to be included in photos and/or videos of classes and events, and for Nevei Kodesh to use those images in any print or online publicity such as, but not limited to, website, brochures, flyers, press releases, private Facebook page, etc. We will not list a child's first or last name in any of our promotional photos. 

Yay - nearly there! Here is your last step to completing registration

When you click the button below to finalize your registration, you should receive an email confirmation of registration.  If you do not, your form didn't go through, so please call our office, 303-443-4567.


Sun, April 14 2024 6 Nisan 5784