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2021-22 SHAFTY Registration
Please verify reCaptcha before submitting the form.
Sr. SHAFTY (9-12 Grade): Congregant Fee $25/ Non-Congregant Fee $36
JCrew (7th and 8th Grade): Congregant Fee N/A**/ Non-Congregant Fee $36
Bonim (5th and 6th Grade): Congregant Fee N/A**/ Non-Congregant Fee $36
Chalutzim (3rd and 4th Grade): Congregant Fee N/A**/ Non-Congregant Fee $36
K2 Club (Kindergarten, 1st, and 2nd Grade): No Fee
**All 3rd-8th Graders who attend Shir Ami Religious School are free
APPLICANT INFORMATION
NECESSARY FOR SENIOR SHAFTY AND NON-CONGREGANTS ONLY
1st Child/Teen Name:
Teen Email:
Grade as of 9/2021
DOB:
2nd Child/Teen Name:
Teen Email:
Grade as of 9/2021
DOB:
3rd Child/Teen Name:
Teen Email:
Grade as of 9/2021
DOB:
4th Child/Teen Name:
Teen Email:
Grade as of 9/2021
DOB:
PARENT INFORMATION
Parent #1 Name and Cell #:
Parent Email:
Parent #2 Name and Cell #:
Parent Email:
Mailing Address:
► SHAFTY Code of Conduct ◄
The drinking, possession and/or distribution of alcoholic beverages, even if the participant is of legal drinking age, is strictly prohibited. Furthermore, no participant may arrive to an event under the influence, even if of legal drinking age.
The use, possession and/or distribution of weapons and/or illegal drugs or paraphernalia relating thereto, is strictly prohibited.
Gambling in any form or manner is strictly prohibited, unless otherwise specifically approved by the adult leadership.
Any inappropriate sexual behavior, harassment, or hazing will not be tolerated.
SHIR AMI FEDERATION OF TEMPLE YOUTH, at its sole discretion shall provide sufficient supervision by adults at all events. Neither Shir Ami, nor its employees, may be held responsible for any damages or injuries sustained by persons or property, directly resulting from improper conduct.
The cost and/or expense of damages resulting from vandalism of any kind, type, or nature must be paid by the person or persons who caused or participated in such vandalism.
No member or members may, of their own accord; (1) extend the time of any sponsored event; or (2) depart from the premises upon which an event is being held, without the knowledge and express permission of an adult supervisor.
Any act that is a violation of Federal, State, or Local laws may be considered a violation of the SHAFTY Code of Conduct.
Any infraction or violation of the SHAFTY Code of Conduct may result in removal of a member at the sole discretion of the SHAFTY advisor(s) at the expense of parent/guardian
NOTE: By completing this application you and your participant(s) agree to abide by the SHAFTY Code of Contact.
MEDICAL DISCLAIMER
It is understood that neither the staff of Shir Ami nor the volunteering parents are expected to administer emergency medical care to any member or guest of SHAFTY.
It is also understood that if a volunteering parent or staff member of Shir Ami administers emergency medical treatment to a member or guest of SHAFTY, then neither the volunteering parent nor the staff member of Shir Ami shall be held liable for said actions.
By checking this box, I hereby acknowledge and agree to said policy.
By checking this box, I hereby acknowledge and agree to said policy.
Allergies, if any:
BABYSITTERS CLUB
Is open to all SHAFTY members in 8
th
-12
th
Grades. Your name, grade, and telephone number will be posted on the SHAFTY Bulletin Board. Your email address will be posted on the Shir Ami website under youth group
Yes! My teen wants to be included in the Babysitters Club! (Name of teen/s):
PARENT YOUTH COMMITTEE
Is a special group of volunteer parents who are committed to supporting, promoting, and facilitating youth activities. The Committee is seeking new volunteers. For information contact
flevy@
shiramipa.org.
Yes! I/we want to be a parent volunteer (Name of Parent/s):
Amount Owed:
*You will be prompted on the next screen for payment.
Sun, May 28 2023 8 Sivan 5783