Bisy Bofty Boca Raton Take over

Parent Information

* Parent 1 First Name:

* Parent 1 Last Name:

* Parent 1 Email Address:

* Parent 1 Phone Number:

Parent 2 First Name:

Parent 2 Last Name:

Parent 2 Email Address:

Parent 2 Phone Number:

* What Temple Do You Belong To?

Ex: Temple Beth El of Boca Raton, Congregation B'nai Israel. If you do not belong to a temple just write N/A.

* What is your Youth Group Name?

Ex: Bisy, Bofty. If you are not sure just write N/A

* How many teens are you registering for?

$72.00 Per Teen Registering

* Please list at least one emergency contact in case parents are not available at the time of event.

Teen 1

* Teen 1, First Name

* Teen 1, Last Name

* Teen 1, Grade Level:

* Teen 1, Cellphone (not a parent's)

* Teen 1, Email (not a parent's)

* Does Teen 1 have any food allergies?

N/A for Nothing

* Is there anything else we need to know about Teen 1, for them to be successful at this event?

Ex: Medical Conditions, Friend Tensions... N/A for nothing

Teen 2

* Teen 2, First Name

* Teen 2, Last Name

* Teen 2, Grade Level:

* Teen 2, Cellphone (not a parent's)

* Teen 2, Email (not a parent's)

* Does Teen 2 have any food allergies?

N/A for Nothing

* Is there anything else we need to know about Teen 2 for them to be successful at this event?

Ex: Medical Conditions, Friend Tensions... N/A for Nothing

Teen 3

* Teen 3, First Name

* Teen 3, Last Name

* Teen 3, Grade Level:

* Teen 3, Cellphone (not a parent's)

* Teen 3, Email (not a parent's)

* Does Teen 3 have any food allergies?

N/A for Nothing

* Is there anything else we need to know about Teen 3 for them to be successful at this event?

Ex: Medical Conditions, Friend Tensions....

* My Teen(s) agrees to follow Temple Beth El's and Congregation B'nai Israel's Code of conduct (which will be read at the start of the event). I understand that if my teen(s) violates the agreement they will be sent home. I understand I am liable for any damages my teen(s) create at the space we are in for this event.

My Teen(s) agrees to follow Temple Beth El's and Congregation B'nai Israel's Code of conduct (which will be read at the start of the event). I understand that if my teen(s) violates the agreement they will be sent home. I understand I am liable for any damages my teen(s) create at the space we are in for this event.By clicking the button above I acknowledge and agree to the statement.

* In the case of an emergency I give permission for the Staff at Temple Beth El of Boca Raton to treat my child.

In the case of an emergency I give permission for the Staff at Temple Beth El of Boca Raton to treat my child.By clicking the button above I acknowledge and agree to the statement.

Total Due:

Wed, May 15 2024
7 Iyar 5784

Today's Calendar

Summer Solidarity Mission to Israel Informational Meeting

: 7:00pm

Friday Night

Blue Jeans Israel Shabbat Dinner

: 7:30pm

Upcoming Programs & Events

May

Summer Solidarity Mission to Israel Informational Meeting
Wednesday, May 15 7:00pm

May

Deconfusing Israel Today
Thursday, May 16 7:00pm

May

Blue Jeans Israel Shabbat Dinner
Friday, May 17 7:30pm

May

The Early Learning Center Class of 2024 Pre-Kindergarten Graduation
Sunday, May 19 1:00pm

May

Rosh Chodesh: Mind, Body, Spirit
Sunday, May 19 7:30pm

Lag BaOmer

Sunday, May 26

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Wed, May 15 2024 7 Iyar 5784