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Family Center Temple Tots – Spring 2017


Welcome to the Family Center Temple Tots Class beginning Thursday, March 9, 2017 and ending Thursday, May 11, 2017.

Flexible 60-minute class structure Drop in anytime, Thursdays 9:30am - 11:00 am, Family Center Room in the Burton Way Building

This program, for children ages 4 months and older, explores topics such as developmental stages, family life issues and any other parenting questions you may have while getting support and advice from an experienced facilitator. This is a wonderful opportunity for parents to get to know one another.

Facilitated by: Emily Glickman, M.A. MFT

Cost: $200 for 8 sessions

*Please note: These rates may be prorated if starting later in the series. If you have any questions about the registration process, please feel free to email Karen Porper, Karen@tebh.org, or call 310.409.2950. We look forward to getting to know you!

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Emergency Contacts



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Health Information for Student #1

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Health Information for Student #2




CONSENT FOR EMERGENCY MEDICAL OR DENTAL TREATMENT:

Either parent, or a guardian having legal custody of a minor may give written authorization for an adult into whose care the minor has been entrusted to consent to X-ray examinations, anesthesia, medical or surgical diagnosis, and/or treatment and hospital care to be rendered to said minor under the general or special supervision and advice of a physician or surgeon licensed under the provisions of the Medical Practice Act, or to X-ray examinations, anesthesia, dental and/or surgical diagnosis or treatment and hospital care to be rendered to said minor by a dentist licensed under the provisions of the Dental Practice Act. AUTHORIZATION: I hereby authorize Temple Emanuel of Beverly Hills and its schools to procure medical, hospital, or dental care for child(ren) named above in the event of injury or illness while the child(ren) is (are) in the care of the above named facility or person(s). I HEREBY RELEASE, DISCHARGE AND AGREE TO HOLD HARMLESS, to the fullest extent permitted by law, Temple Emanuel of Beverly Hills and its schools, employees, volunteers, and other representatives for the provision of this care. I further acknowledge and accept that this Disclaimer, Assumption of Risk and Waiver is intended to be as broad and inclusive as permitted by the laws of the state of California and agree that if any portion of this Disclaimer, Assumption of Risk and Waiver is deemed to be invalid, the remainder will continue in full legal force and effect. ACKNOWLEDGEMENT AND CONSENT: It is further understood that the undersigned will assume full responsibility for any such treatment, including the payment of all costs and expenses. I further acknowledge and accept that this Disclaimer, Assumption of Risk and Waiver is intended to be as broad and inclusive as permitted by the laws of the state in which we live and agree that if any portion of this Disclaimer, Assumption of Risk and Waiver is deemed to be invalid, the remainder will continue in full legal force and effect.

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PRIVACY RELEASE:

The undersigned hereby consents to the use by Temple Emanuel of Beverly Hills of the minor's name, voice, signature, photograph, likeness, and/or work in any manner for the purpose of advertising or promoting the temple and/or its programs.

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All fees reflect a 3% discount for cash or check payments. Please note if paying by credit card, your total will be 3% higher.

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