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In the event that I, or other parent/guardian, cannot be reached in an emergency, I give permission to the Sholem staff to secure proper treatment for my child. If the above physician cannot be reached, I authorize qualified emergency personnel to treat my child. I agree to accept financial responsibility for the costs related to this medical treatment. I acknowledge that it is my responsibility to keep the above information current. I also agree to notify the Sholem School if my child is exposed to any communicable disease.
Culver City, CA 90231
(310) 984-6935 or (818) 760-6625
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