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Camp Kibbutz Emergency Form

Emergency Release Information

Medical Insurance Information

Emergency Contact Information

Alternate Pickup Authorization

Authorization

I, the parent/guardian of the camper(s) listed on this form, authorize OSTNS to obtain immediate medical care and consents to the hospitalization of, the performance of necessary medical tests upon, the use of surgery on, and/or the administration of drugs to, my child(ren) or ward(s) if an emergency occurs when I can not be located immediately. It is also understood that this agreement covers those situations which are true emergencies and only when I cannot be reached. Otherwise, I expet to be notified immediately.

Sat, May 25 2019 20 Iyyar 5779