Consent to be filled out by parent participant* By checking this box, I acknowledge and represent that I am at least eighteen (18) years of age and that I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by agreeing to these terms, and agree to them freely and voluntarily without any inducement.
LIABILITY ACKNOWLEDGEMENT AND WAIVER
By submitting this application, I acknowledge that I have read, understood, and agree:
1. There are certain risks that may occur from participating in this mission to Israel during a War, including but not limited to injury, illness, permanent trauma, kidnapping, or death; and,
2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation; and,
3. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless the Union of Orthodox Jewish Congregations of America (the “Orthodox Union”), their respective officers, directors, trustees, affiliates, agents, employees, independent contractors, consultants, advisors, vendors, volunteers, licensees and assignees (collectively “releasees” and each a “releasee”) from and against every claim, loss, damage and liability or responsibility, including, without limitation, reasonable attorneys’ fees and costs (“liabilities”) arising with respect to any and all injury , disability, death, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.
FOR PARENT/GUARDIAN ON BEHALF OF A PARTICIPANT OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)* By checking this box, I acknowledge and represent that I, as parent/guardian with legal responsibility for this participant, have read this release of liability and assumption of risk agreement, fully understand its terms, consent and agree to my minor child/guardianee’s release as provided, understand that I have given up substantial rights by agreeing to these terms, and agree to them freely and voluntarily without any inducement.
LIABILITY ACKNOWLEDGEMENT AND WAIVER
By submitting this application, I acknowledge that I have read, understood, and agree:
1. There are certain risks that may occur from participating in this mission to Israel during a War, including but not limited to injury, illness, permanent trauma, kidnapping, or death; and,
2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my son’s/guardianee’s participation; and,
3. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless the Union of Orthodox Jewish Congregations of America (the “Orthodox Union”), their respective officers, directors, trustees, affiliates, agents, employees, independent contractors, consultants, advisors, vendors, volunteers, licensees and assignees (collectively “releasees” and each a “releasee”) from and against every claim, loss, damage and liability or responsibility, including, without limitation, reasonable attorneys’ fees and costs (“liabilities”) arising with respect to any and all injury , disability, death, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.
Media Release to be completed by parent.* By checking this box, I acknowledge and represent that I am at least eighteen (18) years of age and that I have read the THE ORTHODOX UNION MEDIA RELEASE, and that I understand it and sign it voluntarily.
ORTHODOX UNION MEDIA RELEASE
From time to time, The Union of Orthodox Jewish Congregations of America, and its programs, employees and agents (together, the “Orthodox Union”) take photographs and videos of individuals, including minors, who attend or participate in Orthodox Union events, programs, and other offerings. The Orthodox Union engages in these activities for purposes relating to the advancement of the religious, spiritual, charitable, and educational goals and objectives of the Orthodox Union, including but not limited to the sharing of photos/videos in newsletters, on our blogs, and on our website and social media pages for the purpose of keeping our members and others informed of the Orthodox Union’s events and other activities. Please complete this form to give us permission to take photos/videos of you and/or your children when you participate in Orthodox Union events or programs and to use those photos/videos in our printed and online publicity:
I hereby authorize the Orthodox Union to take photographs and/or video of me (or my children) when I (or my children) participate at Orthodox Union events or programs. I grant the Orthodox Union full rights to use and share the images resulting from the photographs and/or videos and any reproductions thereof (the “Recording”), in whole or in part, along with my (or my children’s) name, biographical information and quotations for any purpose including fundraising, publicity, advertising, or on social media, all without further obligation or compensation. I hereby waive any right of review or approval regarding the Recording and the Orthodox Union shall have the right to edit or delete the Recording in its sole discretion. I understand that all rights in and to the Recording shall be the Orthodox Union’s sole and absolute property. I understand that if I access the Orthodox Union’s services through a third party platform, product, service, or application (a “Third Party Service”), content and related information generated while accessing OU’s services in this manner may be monitored, captured, and or recorded by the third parties that provide such Third Party Services. I consent to the use and sharing of personal information by any such third party as described in the privacy policy available through the Third Party Service. I release and forever discharge the Orthodox Union from all causes of action, suits, or liability of any kind arising from or in connection with the use or publication of any Recording of me or my children made in connection with my participation in Orthodox Union events. I waive any right of privacy associated with the Recording and I waive any right to compensation related to the use of the Recording.
I HAVE READ THIS AGREEMENT AND AM FULLY AWARE OF ITS CONTENTS, INCLUDING THE RELEASE THAT I HAVE AGREED TO HEREIN.
I warrant that I am at least eighteen years of age and that I have the full and unrestricted authority to enter into a contract for myself (or, if not, that my parent or legal guardian has agreed to the foregoing and signed below).
If any provision of this agreement is held to be unenforceable, the remainder of it shall continue to be in full force and effect.
This waiver shall remain in effect until such time as I advise the OU otherwise in writing.
Media Release FOR PARENT/GUARDIAN ON BEHALF OF A PARTICIPANT OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)** By checking this box, I acknowledge and represent that I, as parent/guardian with legal responsibility for this participant, have read the Orthodox Union Media Release, fully understand its terms, consent and agree to my minor child/guardianee’s release as provided, understand that I have given up substantial rights by agreeing to these terms, and agree to them freely and voluntarily without any inducement.
ORTHODOX UNION MEDIA RELEASE
From time to time, The Union of Orthodox Jewish Congregations of America, and its programs, employees and agents (together, the “Orthodox Union”) take photographs and videos of individuals, including minors, who attend or participate in Orthodox Union events, programs, and other offerings. The Orthodox Union engages in these activities for purposes relating to the advancement of the religious, spiritual, charitable, and educational goals and objectives of the Orthodox Union, including but not limited to the sharing of photos/videos in newsletters, on our blogs, and on our website and social media pages for the purpose of keeping our members and others informed of the Orthodox Union’s events and other activities. Please complete this form to give us permission to take photos/videos of you and/or your children when you participate in Orthodox Union events or programs and to use those photos/videos in our printed and online publicity:
I hereby authorize the Orthodox Union to take photographs and/or video of me (or my children) when I (or my children) participate at Orthodox Union events or programs. I grant the Orthodox Union full rights to use and share the images resulting from the photographs and/or videos and any reproductions thereof (the “Recording”), in whole or in part, along with my (or my children’s) name, biographical information and quotations for any purpose including fundraising, publicity, advertising, or on social media, all without further obligation or compensation. I hereby waive any right of review or approval regarding the Recording and the Orthodox Union shall have the right to edit or delete the Recording in its sole discretion. I understand that all rights in and to the Recording shall be the Orthodox Union’s sole and absolute property. I understand that if I access the Orthodox Union’s services through a third party platform, product, service, or application (a “Third Party Service”), content and related information generated while accessing OU’s services in this manner may be monitored, captured, and or recorded by the third parties that provide such Third Party Services. I consent to the use and sharing of personal information by any such third party as described in the privacy policy available through the Third Party Service. I release and forever discharge the Orthodox Union from all causes of action, suits, or liability of any kind arising from or in connection with the use or publication of any Recording of me or my children made in connection with my participation in Orthodox Union events. I waive any right of privacy associated with the Recording and I waive any right to compensation related to the use of the Recording.
I HAVE READ THIS AGREEMENT AND AM FULLY AWARE OF ITS CONTENTS, INCLUDING THE RELEASE THAT I HAVE AGREED TO HEREIN.
I warrant that I am at least eighteen years of age (or, if not, that my parent or legal guardian has agreed to the foregoing and signed below) and that I have the full and unrestricted authority to enter into a contract for myself.
If any provision of this agreement is held to be unenforceable, the remainder of it shall continue to be in full force and effect.
This waiver shall remain in effect until such time as I advise the OU otherwise in writing.
Parent Program Registration Parent Name*
First
Last
Legal Name of Parent (if Different)
First
Middle
Last
Parent Email
Parent Cell Phone
Parent Date of Birth
DD slash MM slash YYYY
Please note- this is in the Israeli format of Day, Month Year
Parent Nationalty
Parent Passport Number
Parent Passport Expiration
DD slash MM slash YYYY
Please note- this is in the Israeli format of Day, Month Year
Child Program Registration Child Name
First
Last
Legal Name of Child (if Different)
First
Middle
Last
Child Nationality
Child Passport Number
Child Email (If relevant)
Child Passport Expiration
DD slash MM slash YYYY
Please note- this is in the Israeli format of Day, Month Year
Child Date of Birth
DD slash MM slash YYYY
Please note- this is in the Israeli format of Day, Month Year
Child Cell Phone
Whom Should we contact in case of an emergency?
Emergency Contact Phone Number
Emergency Contact Email
Any food needs or allergies?
If you have already booked your flight, please input your flight information here.
Airline & Flight number.
. Time of arrival in Israel on Monday
Please list any important information you would like the trip organizers to know
How many children are coming with you? If you are bringing more than one child, please fill out the second child's information below.
Would you like us to arrange lodging for you? Rate is $190 per night for one room, Monday night through Wednesday night. (This is separate from our trip to the north - the hotel for Tuesday night is already included in the trip fee.)
Donation Amount
Coupon Total
$0.00
Billing Address
Second Child Information Child Name
First
Last
Legal Name of Child (if Different)
First
Middle
Last
Child Nationality
Child Passport Number
Child Passport Expiration
DD slash MM slash YYYY
Please note- this is in the Israeli format of Day, Month Year
Child Date of Birth
DD slash MM slash YYYY
Please note- this is in the Israeli format of Day, Month Year
Name
This field is for validation purposes and should be left unchanged.