RALFTY Senior Potluck (9-12th Grades) - OFFSITE - Event

RALFTY Senior Friendsgiving Potluck!

Saturday, November 23rd, 2024
5:30-7:30 PM
Friendsgiving, Havdallah, Fire & S'mores
Address will be shared the week of the event for privacy & safety reasons.
Teens will be added to a "GroupMe" chat after they have registered for this event!

Contact Clare James, RALFTY Advisor, with questions: ralfty@tboraleigh.org

* Email for Registration Confirmation

What will you bring to the potluck?

Participant Information

* Participant First Name

* Participant Last Name

* Participant's Grade

Participant's Cell Phone

Participant's Email

Is there anything else we should know about the participant's gender identity so we can best support them?

Additional Participant Information

Please provide specifics to the allergies identified above, e.g. which animals, what medicines, which foods, reactions to look for, treatment, etc.

Does the participant carry an Epi Pen?

Does the participant have any MEDICAL issues you would like us to know about?

Does the participant have any behavioral/anxiety/social issues you would like us to know about?

Does your participant carry any medications? Please list all and what they are used for. Ex. Inhaler, Anxiety medication, Allergy Medication, Diabetic Equipment, etc.

Parent/Guardian Information

* Parent 1 First Name

* Parent 1 Last Name

* Parent 1 Email

* Parent 1 Cell Phone Number

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Cell Phone Number

Emergency Contact Information
*We will always attempt to contact Parent 1 & 2 prior to the Emergency Contact. Please list someone other than Parent 1 or 2.

* Emergency Contact First Name

* Emergency Contact Last Name

* Emergency Contact Phone Number

* Emergency Contact Relationship to Participant

Congregation Affiliation Information

Is your family a member of a local congregation?

Is the participant currently enrolled in TBO Religious School?

Has your teen been to a RALFTY event before?

If you are affiliated with a Temple that was not listed, please list it here:

*Electronic Signature Required

Code of Conduct

The undersigned acknowledges that an online signature will, for all purposes, be treated as an original.

* Parent/Guardian Signature

By entering an electronic signature above, a parent or guardian on behalf of each Participant and all parties responsible for Participant, confirms that they have read and understood the NFTY B’rit Kehillah, and understand that if the Participant does not abide by the code of conduct in place, their parents will be contacted and the Participant will be dismissed from the event.

In the mutual interests of Temple Beth Or, the Participant, and for the well-being of all participants at Temple Beth Or, I understand, respect and will observe the rules, regulations and policies of Temple Beth Or, which have been developed for the benefit of all participants, to strengthen the Temple Beth Or program and enhance the experience for all participants. As parent/guardian of Participant, I agree to the implementation and enforcement of the following rules, regulations and policies for Temple Beth Or programming.

RALFTY Senior Potluck (9-12th Grades) - OFFSITE

Saturday, November 23, 2024 • 22 Cheshvan 5785

Register

Code of Conduct