In the event of an emergency which affects the health of the student, I undersigned, do hereby authorize officials of the JEWISH COMMUNITY CENTER to contact directly the persons named on this card and if neither parent nor guardian can be contacted, I authorize the named physician to render such treatment as may be deemed necessary in an emergency, for the health of the child. I hereby give the personnel of the Jewish Community Center of Dallas permission to make arrangements for emergency medical attention, to transport the student to an accredited facility for diagnosis and treatment and to authorize administration of medication as necessary. I request and authorize physicians, dentists and staff of the accredited medical facility to perform any diagnostic procedures, treatment procedures, x-ray treatments and administration of anesthetics as may be necessary in the diagnosis and treatment of minor student. I understand that I have not been given a guarantee as to the results of examination or treatment. I agree to pay for the services rendered and expenses incurred pursuant to this authorization. Further, I will not hold the Jewish Community Center or their Officers, Directors, Administrators, Teachers, Personnel or Employees financially responsible for the emergency care and/or transportation for said child. The authority granted herein will expire one year from acknowledged date.