SOUTHWEST REGION'S KAMP KADIMA APPLICATION

KAMP KADIMA
Camp Young Judaea, Wimberly, Texas
August 31-September 3, 2001

Name_______________________________________________________

Birth Date______________ Grade____________ Sex____________

Address________________________________________________

City________________________ State_______ Zip_________________

Phone___________________________________________

Email ____________________________________________________

Chapter_______________________

Synagogue___________________________

Family's Synagogue Affiliation_____________________________________

PARENT'S CONSENT, AGREEMENT, AND MEDICAL RELEASE

I hereby release Southwest Region Kadima and the United Synagogue of Conservative Judaism of any liability in case of accident en route to or from and throughout Kamp Kadima. My child is responsible for any damage he/she does and/or damage which occurs in his/her room/cabin. I have reviewed the Regional Activities Code, discussed it with my child, and I agree to its conditions.

I understand that there is a $25 late fee for applications received after August 13, 2001 and there is a $25 cancellation fee for cancellations received in the Regional office after August 24, 2001. I further understand that if my child is registered for Kamp Kadima and does not attend and the Regional Office is not notified in writing of the non-attendance before August 27, 2001, there will be no refund of any fees paid. Applications received after August 24, 2001, will be accepted on a space available basis only.

I hereby authorize Will Samuels or his surrogate or (name of Advisor) ____________________________________to give consent for medical treatment for _____________________________________ if such need arises enroute to, from, or during Kamp Kadima and I/we cannot be reached for consent.

______________________________________________(Parent's Signature)

In case of emergency, please contact:

_______________(w)________________(h)_____________Relation____ _______ __

_______________(w)________________(h)_____________Relation____ _______ __

Medical Insurance Company______________________________________

Policy #_________________________

List specific medical information here. This should include allergies, current medications, and medical situations which we should know about. Use additional page if needed.

SOUTHWEST REGIONAL ACTIVITIES CODE

The Southwest Kadima Regional Activities Code has been composed by the Southwest Region Youth Commission with the objective of providing assurance that every individual, every chapter, every congregation involved, the Southwest Region, and International Kadima will derive maximum benefit from every activity and create a safe and positive atmosphere for all participants. The rules are simple and provide for uniform conduct of high standard that govern the action of every person and group. Violations will result in disciplinary action which could include the Kadima member being sent home at their parents' expense and/or suspension from Regional Kadima and USY activities.

  1. No smoking is permitted.
  2. No gambling of any kind is permitted.
  3. No alcohol or drugs are permitted.
  4. Kashrut and Shabbat will be observed in accordance with the practices of the Conservative movement during and enroute to and from Regional activities.
  5. Tallit, t'fillin, and kipot shall be worn as is appropriate during the regional activity.
  6. All attendees will attend all sessions on time.
  7. No Kadima member will leave room or house after curfew.
  8. No Kadima member will leave the area (i.e. Synagogue, hotel, campsite, hosts' home) of the event without permission of the Regional Director.
  9. There shall be no changes in room assignments without the permission of the Regional Director.
  10. Boys will not be permitted in girls' rooms or vice versa at anytime.
  11. Each Kadima member will cooperate with all adult advisors and shomrim.
  12. Each Kadima member is responsible for any damage incurred in his/her room, regardless of the person incurring these damages.
  13. Each Kadima member is responsible for any violation of the rules that occur in their room.
  14. No Kadima member may drive a car to or from any Regional USY event.
  15. No Kadima member may drive a car during any Regional USY event.

 

Male Kadima members (who have had their Bar-Mitzvah) and Advisors MUST bring tallit and t'fillin and wear them at Shacharit services. If you do not have tallit and t'fillin, please discuss with your Advisor or Rabbi how you can get them or borrow them for the convention. Females are welcome to bring and wear tallit and t'fillin if that is their custom. All convention participants must attend all religious services ON TIME.

USYER's AGREEMENT

I agree to abide by the Southwest Kadima Regional Activities Code, tallit and t'fillin policy, and convention rules.

____________________________________(Kadima Member's Signature)

 

Approved for attendance: ____________________________________
(Rabbi, Synagogue Youth Director, or Kadima Advisor)

Please assist your Regional Kadima Crew by indicating any and all parts of religious services you are able to help lead.

Weekdays: Shacharit_____ Mincha______ Ma'ariv______ Torah Reader______ Birkat Hamazon______

Shabbat: Kabbalat Shabbat____ Maariv___ P'zukei D'zimrah____Shacharit____
Haftorah_____Musaf_____Mincha____ Maariv____ Havdallah___

I am a: Cohen______ Levi______ Yisrael______

I am a vegetarian: Yes____ No_____ If yes, do you eat dairy, eggs, or fish? (specify) ____________________________________

Kamp Kadima Fee Information

Please check appropriate box
Kadima Member and Advisor Fee:
[ ] $185.00 before August 13, 2001
[ ] $210.00 after August 13, 2001

[ ] $25 Bus Fee (round trip Austin to Camp) (participants from chapters driving to convention need not pay this bus fee)

[ ] Yad B' Yad contribution: $2.50 (voluntary and confidential) Tzedakah contribution

Fee Enclosed $__________________________
Make check payable to Southwest Region Kadima.

Supplemental scholarships may be available from the Southwest Region. Requests for scholarship should be received in writing, no later than August 13, 2001. Chapter Advisors have applications. (Please determine primary scholarship availability from your own Synagogue & Chapter first.)

TURN IN ALL APPLICATIONS TO YOUR CHAPTER ADVISOR—NOT TO THE REGIONAL OFFICE

 For more information, email Samuels@uscj.org.

The United Synagogue of Conservative Judaism
Southwest Region
4704 Neyrey Drive
Metairie, LA 70002
Phone: (504) 455-5946
Fax: (504) 455-7163
E-mail: samuels@uscj.org

 

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