Register for 3rd Grade Shabbaton

Saturday Dec 15, 9:45am to 3:30pm

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.

Permission Slip
I give my student permission to participate in this Shabbaton.

I give my consent to Mount Zion and designated employees, to make available to my child(ren) professional emergency medical care if such care is indicated. It is understood that conscientious effort will be made to notify me before such action is taken. It is further understood that every effort will be made to contact our family physician prior to any treatment. However, in the event that this is not possible, I give my permission for my child(ren) to receive proper medical care by any doctor, nurse, paramedic or member of a medical staff licensed by the state of Minnesota.

Please initial below to indicate that you have reviewed the rules and expectations together, and understand that my child is expected to follow rules and expectations set by the staff to create a positive environment for learning and socializing for all students. I understand that if my child consistently behaves in a way that creates a negative or unsafe environment, we may ask you to bring your child home.

Participant 1

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Mount Zion is able to accommodate food needs specific to vegan, vegetarian, gluten-free, and dairy-free diets.