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RAC L'Taken Washington D.C. Trip 5784
Friday, February 9, 2024
•
30 Sh'vat 5784
12:00 AM - 12:00 AM 3 days after
Register
Participant Name
Participant E-mail
Participant Cell Phone #
Participant Gender and Pronouns
Emergency Contact #1 - Name
Emergency Contact #1- Email
Emergency Contact #1 - Cell Phone
Emergency Contact #2 - Name
Emergency Contact #2- Email
Emergency Contact #2- Cell Phone
Over-the-Counter Medication Release
Yes
Please contact me first
[FOR LEGAL GUARDIANS] Do you give Jenna (and/or other Trip Chaperones) permission to provide your child with over-the-counter medications? (E.g. Advil, Tylenol) *
Participant Medication Information
Does the trip participant take any regular medication? If yes, please describe the medication, dosage amount, and time of day it should be taken.
Emergency Medical Care Release
Yes
[FOR LEGAL GUARDIANS] Do you give Jenna (and/or other Trip Chaperones) permission to seek medical care for the participant in case of an emergency? *
Dietary Needs
Gluten Free
Dairy Free
Egg Free
Tree Nut Allergy
Peanut Allergy
Sesame Allergy
Stone Fruit Allergy
Other:
Does the participant have any dietary restrictions or food allergies?
Additional Dietary Information
Please use this space to provide any additional information about the participant's allergies or dietary needs, as is needed (specifics, severity, etc.)
I have/will filled out my student's CampMinder form (linked here) for their official registration with L'Taken
I have submitted the CampMinder form
I will fill out the CampMinder form after submitting this form
https://urjrac.campintouch.com/ui/forms/application/camper/App
Additional Information
Is there anything else we should know about this participant?
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Fri, May 3 2024
25 Nisan 5784
Today's Calendar
Men's Monthly Coffee
: 8:45am
ELC Shabbat
: 12:20pm
Shabbat Yeladim
: 5:00pm
CJS Shabbat Meditation
: 5:00pm
Shabbat Community Pizza Dinner - May 2024
: 5:30pm
Shabbat B'Yachad
: 6:15pm
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3
Men's Monthly Coffee
Friday, May 3 8:45am
May
3
ELC Shabbat
Friday, May 3 12:20pm
May
3
Shabbat Yeladim
Friday, May 3 5:00pm
May
3
CJS Shabbat Meditation
Friday, May 3 5:00pm
May
3
Shabbat Community Pizza Dinner - May 2024
Friday, May 3 5:30pm
Yom HaShoah
Monday, May 6
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Fri, May 3 2024 25 Nisan 5784