Kadima Ice Skating- December 2021

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Come join Kadima for ice skating at Bryant Park!

We will meet at the NY Public Library on 43rd & 5th at 2:30 pm.
Pickup will also be at the NY Public Library between 4:15-4:30 pm.

Please send your child with THICK socks and some money to buy cider/hot chocolate and a snack at the Winter Village.

* Child Name:

* Child Phone Number:

* Child Email Address:

* Child Grade:

* Child's Current School:

* Will your child need to rent ice skates?

Please Select OneYes, we need to rent skates ($36)No, we have our own skates ($0)

* Does your child have any allergies or dietary restrictions?

Please Select OneYesNo

* Please describe the allergies/dietary restrictions.

* Child's Doctor: Name, Phone # & Address

* Please list any prescription medications and health concerns that your child may have:

* If the need for medical and/or surgical attention arises during the period of my child's official participation in the Kadima ice skating program by Sutton Place Synagogue, I hereby grant permission for my child to be transported by private vehicle or ambulance to an appropriate medical facility and to be treated by qualified medical authorities at their discretion and that of the program leaders.

If the need for medical and/or surgical attention arises during the period of my child's official participation in the Kadima ice skating program by Sutton Place Synagogue, I hereby grant permission for my child to be transported by private vehicle or ambulance to an appropriate medical facility and to be treated by qualified medical authorities at their discretion and that of the program leaders.

* Does Sutton Place Synagogue have permission to use pictures and/or video of your child on our website/social media or in official digital or printed publications as long as your child is not identified by name?

* Parent/Guardian Name:

* Parent/Guardian Phone Number:

* Parent/Guardian Email Address:

* Who will be picking up your child between 4:15 and 4:30 pm?

* Emergency Contact: Name & Connection

* Emergency Contact's Phone Number:

General Waiver:

I understand that this program will only be offered if the minimum number of participants is reached. I understand that in the event of inclement weather, we will refund the cost of admission.

By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature in reference to the Photo/Video release, medical release, and general waiver. The electronic signature will be equally as binding as an original manual paper signature.

* Electronic Signature

* Date:

Fri, September 20 2024 17 Elul 5784