YOUTH GROUP: Permission Slip & Code of Conduct
This form is required to be on file for all students attending a youth group event for Temple Isaiah.
3rd Grade - ITY BITY
4th Grade - ITY BITY
5th Grade - ITY BITY
6th Grade - JITY
7th Grade - JITY
8th Grade - ITY
9th Grade - ITY
10th Grade - ITY
11th Grade - ITY
12th Grade - ITY
Anything you feel would be important for Lisa/Chaperones to know?
Spots are automatically reserved with payment. Spots are NOT reserved without payment. Refunds are possible with 24 hours notice before an event cancellation. Refunds will NOT be given without this 24 hour prior notice..
ITY BITY (Gr. 3-5) - Maccabee Games - Dec 9, 12-3pm (Free)
JITY (Gr. 6-7) - Ice Skating - Dec 2, 2-5pm ($25)
Permission & Medical Consent
In the event that my child becomes ill or sustains an injury while attending any Youth Group trip, the Temple Isaiah staff has my permission to take whatever steps are necessary to obtain any x-ray, examination, diagnosis, medical or surgical treatment. If the Temple Isaiah staff can’t reach either parent or the physician named below (by telephone), consent is given to any licensed physician to whom our child is taken to perform any necessary medical or surgical treatment. This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. I also give my permission for my child to be transported by bus, private car, or walking.
I, parent/guardian, give consent
Behavior Contract - Code of Conduct
Students AND Parents must acknowledge our Behavior Contract - Code of Conduct to ensure a safe and healthy experience for everyone. Any participant violating this contract will have their parents contacted and removed from the event without any refund. Tshuvah (repentance) will be required before allowed back at any future events if there is a violation..
I will promote the creation of a youth community based on mutual respect and a sense of personal well- being. I will treat others with honor and respect. I have read the following rules, designed to promote the health and safety of all event participants, and have indicated my complete acceptance with my signature and that of my parent/guardian.
I will not posses, consume, or distribute alcoholic beverages while attending this event.
I will not possess, use, or distribute any illegal drug or drug paraphernalia.
I will not smoke or consume or distribute tobacco products at any time during the event.
I will not bring or use any weapons, firearms, or anything that may be construed as a weapon.
I will not commit any illegal act. I understand that vandalism, disturbing the peace or other inappropriate behavior as determined by the chaperones will not be tolerated. I understand that I will have to pay for any damages that I cause. I understand that no gambling is allowed.
I will not participate in any activities that could be deemed as hazing, sexually harassing, demeaning, or hurtful.
I agree to refrain from inappropriate sexual behavior.
I agree to abide by any additional rules, pertinent to the specific event, which may be announced, and to accept the consequences of their violation.
I will attend and participate fully in the entire event, unless otherwise agreed upon with my chaperone or guardian. I will arrive on time, stay to the end, and remain on the event premises at all times.
I understand that these rules of behavior apply from the time I leave home for the event, during the event itself, and until I return home after the event.
We understand that part of the experience involves activities and interactions that may be new for my child. These things come with certain risks and uncertainties beyond what my child may be used to dealing with at home. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk free and so I have to instruct my child on the importance of abiding by the Code of Conduct. My child and I both agree that he or she is familiar with these rules and will obey them. We further understand that sanctions imposed by the chaperone for any violation could include immediate expulsion from the event, at the expense of the parent or guardian.
My signature, and the signature of my parent or guardian, on this form for Temple Isaiah Youth programs, affirms my agreement to the rules and policies of this Code of Conduct.
Name on Card
Address Line 1
Address Line 2
District Of Columbia
Northern Mariana Islands