DRTY: The Lock In You've All Been Waiting For

It's the Lock In You've All Been Waiting for!!!

It's been 2 1/2 years, and it's finally here. Join your temple friends in DRTY for a night of fun, games, and Jewish experience.

June 3, come to JRC for an overnight of youth group FUN!!!

The overnight event at Judea Reform is from 5:30 pm to 10 am. Please dress appropriately for services--you will be able to change after. And bring extra comfortable clothes to wear overnight.

Please plan to arrive between 5 and 5:30 so that we all have time to covid test and get to services!!

This event is open to all Jewish teens, from 8th through 12th grade.

The cost of the event, $18, includes a tshirt, all activities and materials, food, staffing, and other logistical fees.

Vaccines are required for this event (submit proof below). All participants must rapid test at the beginning of the event (rapid tests wilal be provided).

If the cost of this event is prohibitive to your family, please be in touch directly with Rabbi Koppel (EKoppel@judeareform.org). Scholarships are available.

* First Name

* Last Name

* Relationship to teen(s) attending this program

* Email

* Cell Phone

What is the best number at which to reach you during the event?

* Name of Teen Attending Event

Pronouns of Teen Attending Event

* Grade of Teen Attending Event

* Cell Phone

* Submit Vaccine Proof here

Vaccine card or other proof should be submitted here. If the participant cannot be vaccinated for medical reasons, please submit a doctor's note.

Second Teen Attending Event

Pronouns of Second Teen

Grade of second teen

Cell Phone

Submit Vaccine Proof Here

Vaccine card or other proof should be submitted here. If the participant cannot be vaccinated for medical reasons, please submit a doctor's note.

Third Teen Attending Event

Pronouns of Third Teen

Grade of Third Teen

Cell Phone

Submit Vaccine Proof Here

Vaccine card or other proof should be submitted here. If the participant cannot be vaccinated for medical reasons, please submit a doctor's note.

* For any teens listed on this form, please list any allergies, dietary restrictions, medications, or conditions that may impact the teen's participation in this program.

* Emergency Contact during the event if you cannot be reached

* Best Phone Number for Emergency Contact (for the time of the event)

The adult filling out this form and all teens participating in this event must agree to the NFTY Brit Kehillah (Code of Conduct) throughout the event, including any additional rules set forth by the adult leadership. It can be found here: https://nfty.org/wp-content/uploads/sites/32/2018/09/SVP-Brit-Kehilah-Edits1.pdf-1.pdf

* The adult filling out this form has read and agrees to these rules.

The adult filling out this form has read and agrees to these rules.

* All teens listed on this form have read and agree to these rules.

All teens listed on this form have read and agree to these rules.

* I agree to release, hold harmless and indemnify Judea Reform Congregation, its agents, representative, directors, employees, offices, trustees, teachers, youth advisors, and volunteers from all claims, damages or other liabilities for injuries to my son/daughter that are not the result of gross negligence, intentional neglect, or willful conduct by Judea Reform Congregation. I understand this release binds my heirs, personal representatives, and me.

I agree to release, hold harmless and indemnify Judea Reform Congregation, its agents, representative, directors, employees, offices, trustees, teachers, youth advisors, and volunteers from all claims, damages or other liabilities for injuries to my son/daughter that are not the result of gross negligence, intentional neglect, or willful conduct by Judea Reform Congregation. I understand this release binds my heirs, personal representatives, and me.

* I consent to allow Judea Reform Congregation and its agents to provide necessary medical care to my child(ren) for minor injuries such as cuts, scrapes, and bruises. I give my permission for Judea Reform Religious Congregation and its agents to seek emergency treatment for my child(ren). I will assume financial responsibility for treatment rendered. I authorize Judea Reform Congregation to use the image/likeness of my child(ren).

I consent to allow Judea Reform Congregation and its agents to provide necessary medical care to my child(ren) for minor injuries such as cuts, scrapes, and bruises. I give my permission for Judea Reform Religious Congregation and its agents to seek emergency treatment for my child(ren). I will assume financial responsibility for treatment rendered. I authorize Judea Reform Congregation to use the image/likeness of my child(ren).

* By typing my full name in the box below, I confirm the above answers.

Any other information we should know to make this a successful event for all?

* Payment for teens attending this event

Youth & Family