Bar/Bat Mitzvah Shabbaton Permission Form 2025 - Form

Our annual Bar/Bat Mitzvah Shabbaton will take place in Kingston, ON on November 21st and 22nd. The Beth Tzedec Bar/Bat Mitzvah group will spend Shabbat together with a similar Bnai Mitzvah group from Kehillat Beth Israel in Ottawa as well as the Kingston Jewish community.

Toronto participants will leave Toronto by bus late Friday morning and return Saturday evening around 10pm. Ottawa participants should be in touch with KBI for travel information.

Participants will be staying in a hotel that is a 30 minute walk from the Kingston synagogue. All food will be provided and programming will relate to building meaningful group connections and our overall theme of the Bar/Bat Mitzvah marking the beginning of the Jewish teen years.

More information - including a detailed packing list, schedule of activities and drop off/pick up information - will be shared in early November.

Participant First Name

Participant Last Name

Participant Date of Birth (YYYY/MM/DD)

Participant School

Address

City

Postal Code

I Am...

Please Select OneAlready Registered in Beth Tzedec's Bar/Bat Mitzvah ProgramPart of Kehillat Beth Israel's Bar/Bat Mitzvah ProgramFrom the Kingston Jewish CommunityJoining the Shabbaton from a Different Affiliation

Parent 1 Name

Parent 1 Phone

Parent 1 Alternate Phone (if applicable)

Parent 1 Email

Parent 2 Name

Parent 2 Phone

Parent 2 Alternate Phone (if applicable)

Parent 2 Email

Emergency Contact Name (other than parent[s])

Relationship to Participant

Emergency Contact Phone

Emergency Contact Alternate Phone (if applicable)

Is there anything you would like us to be aware of (allergies, medication, social challenges, etc.)?

Please request up to 2 people as potential roomates

Participant OHIP number (include version code)

Permission for Emergency Medical Treatment

I AgreeI Do Not AgreePERMISSION FOR EMERGENCY MEDICAL TREATMENT:
I understand that although Beth Tzedec Congregation and its staff will exercise reasonable care in the supervision of my child, accidents and mishaps may occur. In the case of a medical emergency concerning my child, I give my permission for my child to be transported and admitted to the nearest medical facility and I agree to pay all costs incurred by Beth Tzedec Congregation in obtaining emergency medical care for my child. In addition, I hereby release Beth Tzedec Congregation and its employees and agents from all liability in respect of obtaining any such medical care. I understand and agree that Beth Tzedec Congregation is not liable for anything that may occur due to my providing incorrect information or my failure to give full information regarding the physical condition of my child. By signing this registration form, I also signify that I have custody or legal guardianship of the child for which this application is submitted.

Parental Consent and Release for Youth Excursions

I AgreeI Agree to Participate but not to the Photo/Video ReleaseI Do Not Agree

I, the parent(s) named above, hereby give Beth Tzedec Congregation permission to take the participant named above on the Bar/Bat Mitzvah Program Shabbaton to Kingston, ON, from November 21-22, 2025, by signing below. I, the undersigned, also consent to the use of moving or still pictures and/or film or video footage (collectively, the “Photos”) of my child by Beth Tzedec Congregation (“Beth Tzedec”) for promotional purposes, in exterior signage, in Beth Tzedec publications and marketing materials, and on Beth Tzedec’s web site, in order to promote Beth Tzedec to its membership and to the public.

By indicating my agreement above, I confirm that I am in agreement with the following:

1. I hereby give permission to Beth Tzedec to use the Photos, including my child’s name, image, voice and photographic likeness, without payment or compensation or any other consideration, in all forms and media, for advertising, publicity or programming purposes, and any other lawful purposes, now or hereafter known, throughout the world in perpetuity.

2. I hereby release and forever discharge Beth Tzedec from any and all claims, demands or causes of action which might be made by me, in any way connected with the Photos or the use of the Photos (as described above).