Aberdeen USY Membership Form 2018-2019
Cost:
$55 - for anyone who is a member of Temple Beth Ahm
$100 - for anyone who is not a member of Temple Beth Ahm

This membership form must be filled out completely in order to be processed.

YOUR USY MEMBERSHIP FORM WILL NOT BE PROCESSED UNTIL THE TEMPLE BETH AHM OFFICE HAS RECEIVED YOUR PAYMENT

PLEASE MAKE CHECKS PAYABLE TO: TEMPLE BETH AHM with AUSY in the memo line
Payment may be sent to: TEMPLE BETH AHM, 550 Lloyd Rd., Aberdeen, NJ 07747, Attn: USY

Join our Facebook Group: Aberdeen, NJ USY
Check out our website: http://www.templebethahm.org/usy.html

General Information
Please fill out every question and answer it completely.
What is you Chapter name? *
Aberdeen (307010)
Required
USYer's Email *
Your answer
First Name *
Your answer
Last Name *
Your answer
Home Address *
Your answer
City *
Your answer
State *
Required
Country *
Required
Postal Code *
Your answer
Gender *
Graduation Year *
Date of Birth *
MM/DD/YYYY
Your answer
Cell Phone Number *
Your answer
Parent 1 First Name *
Your answer
Parent 1 Last Name *
Your answer
Parent 1 Phone Number *
Your answer
Parent 1 Email
Your answer
Parent 2 First Name
Your answer
Parent 2 Last Name
Your answer
Parent 2 Phone Number
Your answer
Parent 2 Email
Your answer
Home Phone Number *
Your answer
School *
Your answer
Family Information
Synagogue your Family Belongs To (if any) *
Your answer
Best Way(s) to Reach USYer *
Required
My signature below verifies that all the information is valid to the best of my knowledge. *
E-Sign the Statement *
Signature must exactly match USYer signature on application
Your answer
I have been made aware of the fact that the events in which my child is participating may be photographed by either amateur or professional photographers, which the photographs taken may be used both for purposes of reporting events and programs to Temple Beth Ahm or the greater community. It is my understanding that by initialing and signing this document I consent to the use of the pictures for the following purposes: *
Required
CONSENT, AUTHORIZATION AND RELEASE
Please Read and Electronically Sign Below

Over the course of the year, photographs and videos may be taken during events. Please read the following paragraph and release.

E-Sign the Statement *
Parent Signature *
Signature must exactly match Parent's name on the application
Your answer
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