Sign Up for 7th Grade Sacred Choices Shabbaton

January 5-7

Parent/Guardian Information

Parent or Guardian 2

Emergency Contact Information

Please list a person to contact if we are unable to reach a parent/guardian.

To be read and initialed by a Parent or Guardian:

Event transportation I give my permission for my child to be driven to and from the event by authorized vehicle (bus or automobile with a licensed adult driver) transportation. I understand that my child may not drive to or during the event. I agree to indemnify and hold harmless Mount Zion Temple, their employees, volunteers, and members from any harm which may come to my child while driving to or from the event.

Sacred Choices ~ I understand the content of this Shabbaton includes comprehensive sex education from a Jewish perspective with a focus on Jewish values. I understand my child will be learning about anatomy, sex, and sexuality in addition to values such as shmirat haguf (guarding one’s body). I understand Reform Judaism has a sex-positive approach to sex education, and permits the expression of sexuality within a mature, holy, and committed relationship. I have read all of the materials provided in the Shabbaton Letter, will complete the interview with my 7th grader by January 5th, and will contact Liza Henry with any questions I have.

Photo/Video Release I give my permission to Mount Zion Temple to use any video or photograph, either online or in print, or any video taken at the event my child is attending for the purpose of marketing or promoting Mount Zion Temple programs.

Student 1

List allergies to

MOUNT ZION TEMPLE Brit Kehilah - STANDARD OF CONDUCT FOR YOUTH ACTIVITIES Mount Zion Temple Youth Program values the following:
  • the intrinsic worth and uniqueness of each individual as we are all created Btzelem Elohim – in the image of God
  • programs that are creative, fun, inclusive and educational
  • emotionally and physically safe environments
  • cooperation and mutual respect
  • affirmation of Jewish identity through meaningful communal experiences
  • enhancement of Jewish life through celebration, study, commitment to social justice, and spiritual life
In order to accomplish these values, I agree to follow the following Standard of Conduct. Mount Zion Temple Youth Program Standard of Conduct: The following rules apply from the time I leave home for an event, during the event itself, and until I return home after the event.
  1. 1. I will treat every person with Kavod – honor and respect.
  2. 2. I will attend and participate fully in the entire event, arrive on time, stay until the end, and remain on the event premises at all times, unless otherwise agreed upon with the Adult Leadership.
  3. 3. I am part of Mount Zion Temple Community. Guests must be approved prior to the event or they will be asked to leave.
  4. 4. I will take responsibility for my actions.
  5. 5. I will respect the property of others.
  6. 6. I will refrain from inappropriate sexual behavior.
  7. 7. I will obey all curfews announced by the Adult Leadership.
  8. 8. I will follow any additional rules which apply to specific events as announced by the Adult Leadership.
  9. 9. I will understand that the following activities are strictly prohibited.
    • possession or drinking of alcohol
    • possession or use of any illegal drug
    • supplying alcohol or drugs to anyone else
    • smoking or possessing any type of tobacco products
    • violation of any laws
    • possession of weapons
    • gambling
I have read the above Mount Zion Youth program values and standard of conduct and agree to follow them.

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