STUDENT INFORMATION

PARENT INFORMATION

MEDICAL INFORMATION

In case of need, do you give permission for the chaperones to administer any of the following medications:

EMERGENCY CONTACTS

LIABILITY RELEASE

RELEASE OF LIABILITY:
In signing this form, you are giving permission for your student to attend the New York Trip beginning on February 14, 2025 and ending on February 17, 2025. This trip will be under the direction of Rabbi Kirzane and Cantor Valdman, and other adults acting on Oak Park Temple and KAM Isaiah Israel's behalf. A deposit of $200 is required by no later than November 22, 2024 and can be in the form of check or credit card. Checks should be made out to Oak Park Temple and "New York Teen Trip" should be written in the note. Full payment will be due by no later than 12/13/24.

In signing this form, you are giving permission that in the event of an emergency, when you are unable to be notified, the best available medical treatment may be administered to your child(ren). Please note, if your child takes medication, they will be solely responsible for the administration of that medication. 

In signing this form, you are hereby releasing Oak Park Temple, KAM Isaiah Israel, and those acting on its behalf from all the liability for such harm, except in the event of gross negligence on the part of those in charge of this activity.  

Code of Conduct for New York Trip: 
 1.    Students are expected to be on time and to participate in all programs and events.
 2.    Students are expected to show respect for themselves, for each other, for the staff, for the property of others.
 3.    Electronic devices, head phones, etc. must be used appropriately and not detract from the activities.
 4.    No one should be outside of their room after curfew for any reason unless permission has been granted by a staff member or chaperone.
 5.    Out of respect for privacy, you are only allowed in the sleeping room to which you are assigned.  
 6.    Absolutely no alcohol, drugs, or cigarettes are permitted. Anyone violating this rule will be sent home at once.  Parent(s) will be called to arrange transportation of the students immediately, regardless of the time of day. Additional action may also be taken.
 7.    For this to be a successful group experience, each individual must take appropriate responsibility for his/her own actions and behave appropriately as well as make other students feel included.  

 Violations of these rules may result in a student being sent home early from the trip or other disciplinary action.

PAYMENT OPTIONS