Teen Tivnu Journey 2025-2026 - Form

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TIVNU Journey to Oregon
February 12-16, 2026

Open to all Temple Sinai and Ohr Shalom Members in 8th-10th Grade

This year's tikkun olam trip, for 8th-10th Grade students, will be focused on housing and food insecurity. In partnership with TIVNU, an Oregon-based non-profit organization, students will spend three days working together to help build tiny homes and contribute to urban farming for marginalized populations of Portland. This experience is packed with learning connected to Jewish ethics, social responsibility, and tikkun olam, while also making time for fun experiences that are unique to the Portland area!

To learn more about the TIVNU Portland experience, click here.

Please note: The winter ANAFIM trimester for 8th-9th grade will be focused on
content related to the trip, so we highly encourage signing up for both!

This trip is made possible thanks to a generous grant from
the Jewish Federation of Greater MetroWest.

* Name of Participant

* Student's grade for the 2025-2026 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 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 or publications 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

* Subsidized cost of the trip is $950 per participant. 2 participant per room.

Please Select One$950 — double occupancy3 payment options:
1) If you have a Temple Sinai ShulCloud account, you can pay immediately.
2) If you have a Temple Sinai ShulCloud account, you can opt to bill your account.
2) You can send a check to Temple Sinai.

Send a check payable to Temple Sinai with "Tivnu Trip" in the memoBill my account (only for those with a Temple Sinai ShulCloud account)I will make the payment through my ShulCloud account

Questions? Please contact either of us:

Rabbi Shira Gluck, Associate Rabbi and Director of Congregational Learning, Temple Sinai
Meredith Lubin, Director of Education, Congregation Ohr Shalom

It is our belief that cost should never be a barrier to Jewish education. If you are in need of subsidies, please be in touch with either Meredith Lubin or Rabbi Gluck.