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NFTY-MAR SOUTH DAY

NFTY-MAR SOUTH DAY @ TEMPLE BETH OR, RALEIGH NC
SATURDAY, NOVEMBER 20TH, 2021
5315 Creedmoor Road
Raleigh, NC 27612
11:00AM-9:00PM

Early Bird Cost (Before Nov 5): $30
Normal Cost (After Nov 5): $40

Cost includes: Lunch, Dinner, Snacks, Dessert & NFTY MAR SOUTH Hat

Open to all Jewish teens in grades 9-12.

 

Medical Fields

Participant Information
Please check all that apply.

Parent/Guardian Information

Emergency Contact Information
*We will always attempt to contact Parent 1 & 2 prior to the Emergency Contact. Please list someone other than Parent 1 or 2.

Congregation Affiliation Information

*Electronic Signature Required

Waiver

The undersigned acknowledges that an online signature will, for all purposes, be treated as an original.

I authorize future communications via mail, email, text and phone for the purposes of transactional communications as well as marketing communications for this and other URJ/NFTY/NFTYx programs. Please know that we do not sell or market email addresses. If you do not wish to receive further communications from the URJ and URJ affiliates you will be able to opt out at the time of receipt.

I authorize the use of Participant name, social media user information, and contact information for purposes of URJ and URJ partners/affiliates marketing now known or hereafter devised, worldwide in perpetuity until such time that I choose to unsubscribe.

I consent to the recording, use and reuse by the Union for Reform Judaism (“URJ”) and any of its respective licensees, assignees, parents, subsidiaries or affiliated entities and each of the respective employees, agents, officers and directors (collectively “Releasees”) of the Participant’s voice, actions, likeness, name, appearance and biographical material (i.e. collectively “Likeness”) in any and all media now known or hereafter devised, worldwide in perpetuity. I agrees that Releasees may use all or any part of their Likeness, and may alter or modify it regardless of whether or not the attendee is recognizable. I  further agree that Releasees may use the Participants Likeness and the Materials in connection with any promotion, publicity, marketing or advertisement for the Releasees. I releases Releasees from any and all liability arising out of their use of the Participant’s Likeness and/or the Materials. I agrees not to make any claim against Releasees as a result of the recording or use of the Partcipant’s Likeness and/or the Materials (including, without limitation, any claim that such use invades any right of privacy and/or publicity).

By signing below, parent or guardian on behalf of each Participant and all parties responsible for Participant, confirms that they have read and understood the NFTY B’rit Kehillah, and the rules including those on disciplinary action and indemnification expressly provided immediately above, and agree with all provisions contained herein.

Authorizations:
Participant’s Parent/Guardian gives permission to Temple Beth Or to provide routine health care and seek emergency medical treatment including but not limited to ordering x-rays and routine tests. Participant’s Parent/Guardian gives permission for Temple Beth Or
to release any of Participant’s records necessary for insurance purposes.
• In case of Participant’s medical emergency, the participant’s Parent/Guardian hereby gives permission to the physician selected by
Temple Beth Or to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for Participant, as named above. Information may be printed/photocopied for access in an emergency involving Participant.

Indemnification:
Except with the respect to the sole negligence of the
Temple Beth Or and its employees, the undersigned Participant’s Parent/Guardian hereby release, discharge, and hold harmless Temple Beth Or and their employees from any and all claims, lawsuits, or other legal causes of action, which relate to the undersigned Participant’s participation in a Temple Beth Or Program, and the Participant’s travel to and from Temple Beth Or, such events and programs, and related activities

Terms and Conditions Agreement:
The below Terms and Conditions between
Temple Beth Or and my child (hereafter “Participant”) represent the expectations and agreements in order to participate in a Temple Beth Or-sponsored activity:

In the mutual interests of Temple Beth Or, the Participant, and for the well-being of all participants at Temple Beth Or, I understand, respect and will observe the rules, regulations and policies of Temple Beth Or, which have been developed for the benefit of all participants including Participant to strengthen the Temple Beth Or program and enhance the experience for all participants. As parent/guardian of Participant, I agree to the implementation and enforcement of the following rules, regulations and policies for Temple Beth Or program

Requirements for Acceptance to Session at Temple Beth Or:
  • I agree that the Participant's participation in Temple Beth Or activities is not confirmed until explicit written verification is received from Temple Beth Or, which notice will usually come to Participant and his/her family, including me, via email.
Refund of Payment Policies:
  • All cancellations must be in writing. We will accept cancellations by email to Temple Beth Or. Refunds will be processed and returned within six weeks after the conclusion of the event.
  • Refunds will be given based on the following schedule
    • A 90% refund will be given 21 days prior to event date.
    • A 75% refund will be given 14 days prior to event date.
    • A 50% refund will be given 8 days prior to event date.
    • No refunds will be given 7 or fewer days prior to event date with exception of a documented medical emergency in which case a 75% refund will be granted.
  • Refunds will not be made if Participant has attended any portion of the session at Temple Beth Or. This covers all circumstances, including, but not limited to:
    • Participant’s homesickness
    • Participant’s refusal or inability to participate in the normal activities
Participant’s violation of any rules, regulations, or policies at Temple Beth Or for which Participant has been provided notice, and as described below in “Participant’s Participation and Temple Beth Or Program Expectations” section. Furthermore, I understand I will be responsible for the cost of my participant leaving the program early due to violation of the rules.

*Electronic Signature Required

COVID Protocol Waiver

The undersigned acknowledges that an online signature will, for all purposes, be treated as an original.

In an effort to align with current policies at the Reform temples in the area, county Board of Education policies, and with the health and safety of participants in mind, mask will be required at all event activities while on the grounds of Temple Beth Or. This includes during both inside and outside activities except while the participant is in the act of eating or drinking during designated meal/snack times.

Mask should cover both the participant's mouth and nose at all times when a mask is required.

Refusal to wear a mask at designated times will result in one warning. If the participant is found to not be wearing a mask as described above again, 

- the participant will be removed from the activity and separated from other participants, 
- the participant's parent/guardian will be contacted to come to the event and pick up the participant,
- the participant will remain separated from other participants until the parent/guardian arrives.

If the participant is asked to leave the event, this will be viewed as the Participant’s violation of the rules, regulations, or policies at the SOUTH DAY Event for which Participant has been provided notice. Furthermore, I understand I will be responsible for the cost of my participant leaving the program early due to violation of the rules.
I will not send my child to the SOUTH DAY Event if:

- the participant has tested positive for COVID within 10 days of the event, 
- a member of the participant's household has currently positive for COVID, or 
- the participant has been exposed to a known positive COVID case within two weeks of the event and the participant has not received a negative test result since the exposure to ensure the participant does not have COVID.

If my child or a member of my household tests positive for COVID following the event, I will communicate by email to hdemick@tboraleigh.org in order to inform the SOUTH DAY Event Planning Committee/Temple Beth Or and its participants of possible exposure. The child/families name will not be disclosed in the event of necessary communication of an exposure to the SOUTH DAY attendees. 
Fri, April 19 2024 11 Nisan 5784