7th and 8th Grade Shul In and BBYO Connect Event

Please Complete separate registration form for each child participating.

7th and 8th Grade Shul-In & BBYO Connect Event
Drop Off: Saturday, February 11, 2023 at 5:00 pm
Pick Up: Sunday, February 12, 2023 at 9:00 am or 12:00 pm

Costs:
7th and 8th grade shul-in (inclusive of BBYO Connect Event) - $15.00 per person
BBYO Connect Event ONLY (5:00 pm to 7:00 pm) - $5.00 per person

(If your 7th or 8th grader works as an MIT/Madrichol on Sunday mornings, pick up will be at 12:00 pm. If your child does not participate in our Sunday morning programs, pick up will be at 9:00 am)
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Do you remember the fun that came with spending the night at your temple? Then you will want your 7th or 8th grader to join us for a night to remember at TTCBJ!

This event will include dinner, sweet treats, lots of games, a movie on our big screen, temple “after dark” with your grade level friends, and all the fun you can handle! The Gaga Pit will be set up too!! We will also have breakfast together in the morning.

The event begins at 5:00 pm. From 5:00 pm to 7:00 pm we will be partnering with BBYO Connect to participate in a service project. We are so excited about this collaboration.
After the BBYO Connect event ends at 7:00 pm the sleepover will commence.

If you are planning on picking your child up early instead of them spending the night,
please let us know!

A Minimum of 10 kids needed to make this event happen.

Let us know today if you are interested and pass the word around to your friends!

Category of Attendee

Please indicate whether you are joining us ONLY for the BBYO event or planning to stay overnight for the Shul-In.

My child is ONLY coming to the BBYO Connect event from 5:00 pm to 7:00 pmMy child will be in attendance for the whole overnight programMy child will participate in the shul in following the BBYO Connect program however I will be picking them up early Saturday night.”

* Congregation (if not B'nai Jehudah members)

Non-B'nai Jehudah Member Medical Information for Participant

If you are not a member of B'nai Jehudah; please fill out the medical information indicated below.
***B'nai Jehudah members do NOT need to fill out this section***

Participants Doctor's Name and Phone Number

Allergies

Please list all allergies below

Medications

Do these medications need to be administered by an adult or by your child?

YesNo

Family Health Insurance Provider

Insurance Policy #

Insurance Group #

Policy Holder Name and Relationship to Student

Participant Medical/Developmental Challenges

DiabetesEpilepsyNoneOther

Participant Medical Challenges - detail

If there are none, please type "N/A"

Please indicate any other medical or developmental challenges we need to be made aware of below

Parent/Guardian Information

* Parent/Guardian First Name

* Parent/Guardian Last Name

* Parent/Guardian Phone

* Parent/Guardian Email

Participant Information

* Participant First Name

Participant Preferred Name/Nickname

* Participant Last Name

* Preferred Gender

She/HerHe/HimThey/ThemOther

* Participant Phone

* Participant Email

Is there any additional information about your child that we should know?

If not, please type "N/A"

Food

Food Requirements

Gluten FreeDairy FreeVegetarianOther

"Other" food requirements? Please explain:

Emergency Contact Information

(Be sure that the emergency contact person listed will be available if needed during this event on February 11-12, 2023.

* Emergency Contact Full name

* Emergency Contact Phone Number

Code of Conduct Agreement

* Conduct Agreement

Conduct AgreementParticipant agrees to participate in the programming and behave in a respectful and appropriate manner.

Registration Fees

* Registration Fees

Please Select One7th and 8th grade Shul-In (includes BBYO Connect Program)BBYO Connect Program Only (5pm to 7:00 pm)

REFUND POLICY: If a minimum of 10 participants do not register, a full refund will be given. A partial refund may be given if the Participant cancels their registration within 3 days prior to the event.

Saturday, February 11, 2023 • 20 Sh'vat 5783

Register

Parent/Guardian Information

Participant Information

Emergency Contact Information

Code of Conduct Agreement

Registration Fees