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A-HEC of a Summer 2019
ALL scrub tops and scrub pants are unisex
MEDICAL INFORMATION
**Due to the potential risk of harm to the unborn fetus, pregnant females will not be allowed to participate in this program. If you are or believe you may be pregnant notify CLAHEC immediately.**
Acceptance into the "AHEC of a Summer program requires a commitment of approximately 105 total hours of weekday volunteer service at the host medical facility during the month of June. Volunteers do NOT receive wages or salary through the "A-HEC of a Summer" program. Volunteers will receive 1/2 unit of high school credit upon satisfactory completion of the program. Signing this application is an indication of your availability and commitment to participate in ALL scheduled "AHEC of a Summer" activities. I hereby give my child permission to apply for the "A-HEC of a Summer" program. I have read the program brochure and agree to adhere to the program policies and to provide transportation for my child to the program site if he/she is selected. My signature also authorizes Central LA AHEC the use of my child's image and statements; uses include, but are not limited to: photography, videotape, organization web site, or social and/or print media. Additionally, I grant Central LA AHEC permission to use my child's personally identifiable information for the purposes of federal, state and grant tracking and reporting.
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