AMUSY-BHUSY-BJUSY Interchapter Shabbaton
Join AMUSY, BHUSY, and BJUSY for an incredible Shabbat together hosted at AMUSY!
Program highlights include:
Musical Shabbat services Friday night
Programming planned by the incredible chairs!
Bus transportation to the CHUSY SA/TO lockin Saturday night (separate minimum donation and registration at
Friends, fun, food and so much more!
Cost for Interchapter is only $85
All 8th-12th grade Jewish teens may attend Interchapter regardless of whether or not they are attending SA/TO Marathon.
Any questions about Interchapter please contact:
USYer First Name
USYer Last Name
Home Synagogue/USY Chapter
Am Yisrael (AMUSY)
Beth Hillel B'nai Emunah (BHUSY)
Congregation Beth Judea (BJUSY)
USYer Cell Phone
Check made out to Am Yisrael
Check made out to Beth Hillel
Check- Made out to Congregation Beth Judea
Emergency Contact Name and Relationship
This should be different from parent information. We will always try to contact parents first.
Emergency Contact Phone
Please list any specifics the staff should be aware of while your child participates in this program.
Do you need to stay in walking distance of Am Yisrael?
I am from Am Yisrael and will be staying at my own home
Please specify any pet allergies that we need to know about for housing purposes
I hereby authorize the staff to seek medical emergency assistance for my child if required. I also hereby fully release and discharge Congregation Beth Judea, Its agents and property owners from any and all claims from injuries,damage or loss which may accrue to my child on account of his/her participation in events sponsored by Am Yisrael, Beth Hillel, and Congregation Beth Judea's Youth Department. I also authorize use of photographs and videos taken during programs to be used by Congregation Beth Judea for various purposes including but not limited to, advertising, sharing around the synagogue, and posted on various social media platforms.
I further agree to indemnify, hold harmless and defend Am Yisrael, Beth Hillel, and Congregation Beth Judea and its agents from any and all claims resulting from injuries, and losses sustained by my child and arising out of,connected with, or in any way associated with the activities of these programs or events.
Parent/Guardian Digital Signature
I have read the above and agree to this Release Form. Also, I understand this form is specific to this program and does NOT apply to other CBJ programs or activities.
Any Additional Information or Questions?
A copy of your responses will be emailed to the address you provided.
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