L'taken 2024-2025 - Form - Temple Sinai Summit

IF YOU ARE A MEMBER, PLEASE LOGIN.

This will insure proper credit to your account. Login at the top right corner. If you are accessing this form through your phone, click the 3 line menu at the top right corner.

L’taken Seminar in Washington, D.C.
February 21-24, 2025
open to all Temple Sinai members in 10th grade*

Temple Sinai’s 10th graders will join hundreds of teens from Reform synagogues around the country for a social justice seminar in Washington, DC. In partnership with the Religious Action Center of Reform Judaism (“the RAC”), our teens will have the opportunity to learn about social justice issues from a Reform Jewish perspective and then advocate for these issues on Capitol Hill. The program is designed to both expose them to a variety of public policy issues and explore the Jewish values that inform the Reform Movement’s advocacy around these issues. We will also visit the United States Holocaust Memorial Museum, www.ushmm.org, the Smithsonian National Mall and celebrate Havdalah at the Jefferson Memorial.

See a video of the L'taken weekend here
Learn more about the RAC and L’taken here
and see a sample itinerary for the trip here.

*Grades 11 and 12 are invited to participate, with preference given to 10th-grade students if space is limited.

* Name of Participant

* Student's grade for the 2024-2025 school year?

* Participant's Cell Number

* Participant's Email Address

* Parent 1 First Name

Parent 2 First Name

* Parent 1 Last Name

Parent 2 Last Name

* Parent 1 Cell Number

Parent 2 Cell Number

* Parent 1 Email

Parent 2 Email

* Does your teen take any medication regularly? If yes, please describe.

* Please list any allergies, including food sensitivities, and describe in detail.

* Does your teen carry an Epi-Pen?

Please Select OneYesNoIf your teen has a prescription, they are required to bring an up-to-date Epi-Pen on the trip with them.

* Do you grant permission to trip leaders/chaperones to administer over-the-counter medications as needed? (e.g. oral antihistamines or analgesics.)

YesNoCall me first

* In case of emergency, parents will be contacted first. In the event that a parent cannot be reached, please list name, cell phone, and relationship to teen for an additional emergency contact.

* Photo release

YesNoI hereby grant permission to ANAFIM, a collaboration of Congregation Ohr Shalom (COS), and Temple Sinai (TS), to use this teen’s photographic likeness, alone or in a group, in any internal publication and/or to release this child’s/these children’s photographic likeness to any newspapers and/or magazines for publicity and/or recognition purposes relating to COS and TS. I understand that the teen will never be identified by name without express permission. Additionally, I extend this permission to use this teen’s photographic likeness, alone or in a group, on the official websites and social media accounts of COS and TS. I release COS and TS, its board members, employees, agents, servants, representatives and all organizations and individuals related to COS and TS from any and all liabilities or damages that result from the use of this teen’s photographic likeness on the official websites, publications, and social media accounts of COS and TS. I represent that I am authorized to act on behalf of this child/these children. My permission shall remain in effect unless and until revoked by me and communicated in writing.

* Parent Electronic Signature

* Cost of the trip is $700 per participant. This is based on quadruple room occupancy. All rooms have two queen-sized beds. It is not permitted to add cots to these rooms. There is a $75 supplement for triple occupancy and $125 for double occupancy. Single occupancy is not permitted for teen participants.

Please Select One$700 — quadruple occupancy$775 — triple occupancy$825 — double occupancyIf you have a Temple Sinai ShulCloud account, we will bill you the amount selected.

Send a check payable to Temple Sinai with "L'taken Seminar" in the memoBill my account (only for those with a Temple Sinai ShulCloud account)