June 17, 2015

Dear Parents,

We are looking forward to a really fantastic, fun and meaningful week with your daughter/s.  Please sign the Permission form below and mail it back to us by June 30th.


Permission Slip/Liability Waiver


As the parent/legal guardian of _________________________________

 I am in complete understanding that my child is participating in activities sponsored by the Valley

Friendship Circle Esmach Summer Circle for Girls.

 I fully understand and choose not too, and will not hold Valley Friendship Circle, any of its agents, assigns, employees, partners, volunteers or volunteer sponsors or Chabad of Studio City (hereafter all referred to as sponsors), liable for any accidents, injuries, or any other unforeseen harms incurred at any time while participating in this activity under any circumstances.


 I authorize Valley Friendship Circle and its’ sponsors to find adequate and reasonable medical treatment at my expense, if the need arises.


This waiver will serve as a medical release form, thus authorizing the sponsor permission to act on my behalf until such a time that I can be contacted. 


I also allow my child_________________ to be driven to and from Esmach Summer Circle locations/ 11927 Ventura Blvd & 4448 Simpson Ave.


I hereby give  _____________  permission to attend and be driven to the following local  outings: (All are located in Studio City or Sherman Oaks)


Bowling @ Pinz []                    Weddington Park []                 Sandbox Fitness []

Brenenson Family Pond []                  Nail Salon []

I understand that by signing below, as the parent/legal guardian, I agree to and will adhere to the preceding statements and grant permission for my child to participate in this program.


Also, I understand that my child will not be allowed to participate if they are not accompanied by this completed form before the activity begins.



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