Kamp KEF 2023

May 30 - June 2, 2023

Cost: $200 Members, $250 Non-Members

20% discount for each additional child
($160/$200 per additional child)

Before or After Care: $20 per child
Before and After Care: $40 per child

* Member or Non-Member Registration?

(Choose one)MemberNon-member

* Number of Campers (members)

* Number of Campers (non-members)

Number of Campers in Before Care - $20 per camper

Number of Campers in After Care - $20 per camper

Total

Contact Information

* Parent/Guardian - Primary Contact

* Primary Contact Phone Number(s)

* Parent/Guardian - Secondary Contact

* Secondary Contact Phone Number(s)

* Emergency Contact (if parents can't be reached)

* Emergency Contact Phone Number(s)

* Doctor

* Doctor Phone Number(s)

* Hospital Preference

Release Forms

* Media Release - My child(ren) registered for Kamp KEF have my permission to have their work and/or photograph posted on Beth El Synagogue's electronic and print media, including but not limited to promotional video, Web pages, social media, and monthly newsletters.

(Choose one)YesNo

* Kamp KEF Waiver and Release - I hereby consent to my child's attendance at and participation in the activities provided at Beth El Synagogue's Kamp Kef. I hereby release, on behalf of myself, my child, any other legal parent or legal guardian of my child and all persons that may have a potential claim, demand or cause of action of any kind whatsoever, against Beth El and its clergy, officers, employees, agents, representatives and volunteers from any and all liability relating to, arising out of or in connection with Kamp KEF and/or my child's attendance at and/or participation in Kamp KEF and camp activities, including, but not limited to, any illness or injury sustained at Kamp KEF. I hereby voluntarily assume full responsibility for any risk of loss, property damage or personal injury that may result from my child's participation in activities at Kamp KEF. Further, I hereby specifically release and hold harmless Beth El Synagogue and its clergy, officers, employees, agents, representatives and volunteers from any actions associated with obtaining, or refraining from obtaining, necessary medical treatment for my child in accordance with my instructions. I agree to remain fully liable and responsible for the payment of any hospital, doctor, ambulance, dental or medical fees incurred by my child. I further agree that Beth El Synagogue does not assume any responsibility or liability for the payment of such fees which may be incurred. I agree to indemnify Beth El Synagogue for any claims brought by me or a third party for any costs associated with defending or litigating such claims including, but not limited to, attorney's fees, costs and legal expense.

Kamp KEF Waiver and Release - I hereby consent to my child's attendance at and participation in the activities provided at Beth El Synagogue's Kamp Kef. I hereby release, on behalf of myself, my child, any other legal parent or legal guardian of my child and all persons that may have a potential claim, demand or cause of action of any kind whatsoever, against Beth El and its clergy, officers, employees, agents, representatives and volunteers from any and all liability relating to, arising out of or in connection with Kamp KEF and/or my child's attendance at and/or participation in Kamp KEF and camp activities, including, but not limited to, any illness or injury sustained at Kamp KEF. I hereby voluntarily assume full responsibility for any risk of loss, property damage or personal injury that may result from my child's participation in activities at Kamp KEF. Further, I hereby specifically release and hold harmless Beth El Synagogue and its clergy, officers, employees, agents, representatives and volunteers from any actions associated with obtaining, or refraining from obtaining, necessary medical treatment for my child in accordance with my instructions. I agree to remain fully liable and responsible for the payment of any hospital, doctor, ambulance, dental or medical fees incurred by my child. I further agree that Beth El Synagogue does not assume any responsibility or liability for the payment of such fees which may be incurred. I agree to indemnify Beth El Synagogue for any claims brought by me or a third party for any costs associated with defending or litigating such claims including, but not limited to, attorney's fees, costs and legal expense.

* Electronic Signature

I have carefully read and understand this Waiver and Release.

* First Name

* Last Name

* Email Address

Sat, April 1 2023 10 Nisan 5783