Participant's Name *

First Name

Last Name

Participant's Birthdate *

MM

DD

YYYY

Camp

Berkshires

California

Canada

Darom

Galim (Northern California)

New England

Nyack

Poconos/Philadelphia

Rockies

Wisconsin/Chicagoland

Parent or Guardian's Name *

First Name

Last Name

Parent/Guardian Cell Phone Number *

(###)

###

####

TikvahNet Participation Waiver *

I give my child(ren) permission to participate fully in TikvahNet for Winter 2023. I understand and agree: I retain full supervisory responsibility for any and all activities that happen as a part of TikvahNet. Camp staff refers to adults who have been screened, approved and trained and may be paid staff or volunteers. I will not expect camp staff to provide supervision for my child. I understand that participation in these events is at my and my child’s own risk. While measures are being taken to manage any risk, there is still the risk that something unexpected may happen. If my child gets hurt while participating in any National Ramah chug or activity recommended by National Ramah, I will assume full responsibility. I agree that if my child is under 13 years of age, I will maintain and supervise any online accounts that they may participate in. I agree that if my child is 13 or over, I am giving them permission to participate in any National Ramah activity that they may access through Zoom or other National Ramah-approved platforms. I understand that National Ramah may send my child communications via email to the campers’ email address (if provided in the registration form). I understand that two-way sessions (such as Zoom) that my child participates in will be closed and will only allow registered participants and approved staff and volunteers to participate. For all two-way sessions (such as Zoom), I will ensure that my child is appropriately dressed and that the computer and camera that they are using does not show inappropriate things in our home. If staff notice something on my child’s video that they determine is not appropriate, I understand that staff will turn off my child’s video until the issue is resolved. Appropriate behavior for participants will be expected. Camp staff will review appropriate and inappropriate behaviors with campers. Bullying, including cyberbullying, during a session or outside of a session will not be tolerated. Issues and consequences will be addressed with campers and parents, including but not limited to, temporary or permanent removal from TikvahNet. I agree that if my child or I upload any photos or videos of my child, our family, and/or their activities, I am giving permission for them to be used and shared publicly. I understand that all sessions will be recorded and my child will be in either a screenshot and/or video record. These recordings or screenshots may be used by National Ramah for current or future marketing efforts.

I confirm that I have read the TikvahNet Waiver and above permission statements, that I understand them, and that I agree to be bound by them.