N'siyah Enrollment 2020-2021

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We are so excited for our N'siyah Teen programming for 2020-2021! We are offering a variety of programs and opportunities for 8th-12th graders, and we can't wait for you to join us!

* Teen's Name:

* Teen's Email:

* Teen's Cell Phone Number:

* Teen's School in 2020-2021:

* Teen's Grade in 2020-2021:

* How is Teen attending school in 2020-2021?

* Teen's DOB:

* Teen's Age:

Teen's Hebrew Name:

* Teen's Gender:

* I give my Teen permission to self-dismiss from all in-person events.

* 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 Teen is not identified by name?

* How has your Teen adapted to virtual school and activities?

* Does your Teen have any allergies or other needs that might limit the activities in which they can participate? If yes, please describe them.

* Does your Teen have an IEP at school or any accommodations that might help us to make N'siyah programming more meaningful? If yes, please describe them.

* Is there anything else you'd like us to know about your Teen?

* Does your Teen have any allergies? If yes, please explain.

* Does your Teen take any prescription medications? If yes, please explain.

* In case parents/guardians are unreachable, whom should we contact in case of emergency? Please list their name, phone number, and relationship.

* Physician's Name, Phone Number & Address:

I accept that:

To participate in N'siyah programming, Teen families must be members in good standing of Sutton Place Synagogue.
Placement of children in a particular class is at the discretion of our education director.
I release Sutton Place Synagogue from all responsibilities other than supervised N'siyah activities.
If and when the need for medical and/or surgical attention arises during the period of my child's official participation in the N'siyah program of 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.

* Parent/Guardian 1 Name:

* Parent/Guardian 1 Email:

* Parent/Guardian 1 Cell Phone Number:

Parent/Guardian 2 Name:

Parent/Guardian 2 Email:

Parent/Guardian 2 Cell Phone #:

* Choose your N'siyah journeys:

Wednesdays with Hannah: Exploring Jewish Values ($360)Israel and Me: Current Conversations with Alyssa ($360)BOTH Wednesdays with Hannah & Israel and Me with Alyssa ($600)N'siyah Social Events (No fee for registration; specific events may have a fee)Havdallah with the Rabbis (no fee)Teen Advisory Council (no fee)Madrich Track (no fee; earn service hours)Internships with SPS (no fee; earn service hours)Please note that if you register for both Wednesdays with Hannah and Israel and Me with Alyssa, you get a discounted price of $600.

We never want finances to be a barrier to participating in our N'siyah programming, and financial assistance is available. Please contact Hunter Gold (hgold@spsnyc.org) to discuss.

Wed, April 24 2024 16 Nisan 5784