32nd Annual Northeast Family Shabbaton
May 4th - 6th, 2018
Crowne Plaza Hotel
2701 Summer Street Stamford, Connecticut

For additional information or questions, contact Ahuva Stern, Coordinator of Special Events, SternA@ou.org or 212-613-8301

If you require a scholarship, please contact Ahron Rosenthal BEFORE filling out the application. RosenthalA@ou.org or 212-613-8266.

PARENT/ GUARDIAN INFORMATION (ONLY THOSE ATTENDING)

Please List all Non Married Children Attending:

Due to overwhelming request, Yachad will once again be running a series of programs and workshops for children of all ages.
Siblings are welcome and encouraged to attend.

MARRIED CHILDREN OR OTHER FAMILY ATTENDING

Please list children attending with "other relative":

ROOMING REGISTRATION

PLEASE FILL OUT ACCORDING TO HOW MANY ROOMS YOU WILL BE OCCUPYING

*Yachad will try its best to accommodate requests, but cannot guarantee them

Room 1



(King Bed rooms have ONE bed with a pull out couch; Double Bed rooms have 2 full-size beds)



Names of people staying in the room:

Note: if you choose to have your family member with a disability room with a Yachad advisor (this is available for ages 8+) please do NOT list them here.

Please check if you will need the following:




* There is an additional charge for cots and cribs. $15 per item for the weekend.

MEAL SEATING

If you have a request for whom you would like to sit with at meals, Yachad will try its best to honor those requests for at least ONE of the Shabbat meals.

Typically, we will seat all family members together Friday night. For Shabbat lunch, family members with a disability will sit with their advisor and peers.



**In order to help families keep in touch, we will be compiling a contact list to send out after the Shabbaton.

CHILD / ADULT WITH DISABILITY INFORMATION



* All individuals under the age of 8 MUST room with family









Medication


NAME:
(specific name of the medication)
TIME GIVEN:
Morning Afternoon Evening
DOSAGE:
(amount of)
DESCRIPTION:
(Size, Shape, Color)
PURPOSE:
(why medication is given)
Procedure to follow if medication is missed

Please check off all that applies to your child in order to help our staff work with him or her throughout the weekend:






LEARN ABOUT YACHAD

Yachad is proud to offer an array of social/recreational/educational services to you and your family. Please select from the list below of departments you would like to learn more about. There will be networking time available over the course of the weekend.



TRANSPORTATION REGISTRATION

Please Note: Transportation is not provided for this Shabbaton, with the exception of one bus leaving from Brooklyn with a stop in Manhattan. There is a round trip transportation fee of $60 per person. Transportation is available on a first come, first serve basis.

**There will be only one bus. Get your reservations in early as there is limited seating**



Buses will leave the hotel at Noon on Sunday



Name: Contact Number:
(Cell # preferably)
Email:


* For further questions about transportation please contact Ahuva Stern at 212-613-8301 or SternA@ou.org

SHABBATON PAYMENT

Applications are not considered completed until payment has been received by the Yachad office or a payment plan has been initiated. Reservations can only be guaranteed once an application is complete.
If you require a scholarship, please contact Ahron Rosenthal BEFORE filling out the application. RosenthalA@ou.org or 212-613-8266

Adults at $275 per person
(Anyone 12 years old and above is considered an adult)
Children 7-11 at $140 each
Children 3-6 at $80 each
Children 0-2 FREE
Crib $15
Cot $15
Refrigerator FREE
Transportation (From Brooklyn and Washington Heights only) $60 per person

Application Details
Description Quantity Unit Price Total

Payment Option