Youth Education Form 2022-2023 - Ramat Shalom Synagogue

11301 W. Broward Boulevard, Plantation, FL 33325 954-472-3600/ Fax 954-472-3622 ramatshalom@ramatshalom.org

iSERVE/ Program Description

iServe is an innovative program for Ramat Shalom’s Post B’nai Mitzvah, Confirmation and Post-Confirmation teens that focuses on the Jewish concepts of G’milut Hasadim (deeds of loving kindness) and Tikun Olam (actions to repair the world). The goal of iServe is twofold: (1) to educate teens about the needs in their community; and (2) to give them the resources & the opportunity to go out and heal the world. Throughout the year, iServe teens will contemplate, plan and engage in various meaningful, hands-on community service projects that will strengthen their Jewish identity and reinforce their Jewish values. Some highlights include: a challah bake for the food-insecure of Broward County; two beach clean-ups, bingo night with U.S. Veterans; a 6,000 lbs. food challenge for the Harvest Drive; and so much more! Service hours are available for iServe activities. iServe is open to all 8th-12th graders. At the end of 10th grade, iServe, students whose families take part in our Congregational Plan are eligible for Confirmation.

Kochavim/Youth Choir

A love of music is the only requirement for participation in this group! Rehearsals take place approximately once per month on Sundays, immediately following Torah School. Social opportunities and camaraderie are plentiful as the choir prepares for several performances throughout the year. Lunch is provided.

Please indicate which program you are selecting. Please submit one form for each child!

iSERVE Program (Gr. 8 – 12) – $190 Non-member – $225
Kochavim / Youth Choir (Gr. K-7) – $80 Members only

Child's Name: *

Hebrew Name: *

Phone: *

Email: *

School: *

Grade in School 2022-2023: *

Torah School Grade: *

Date of Birth: *

Age on 8/1/22: *

Identified Gender: *

Parent 1 Name: *

Parent 2 Name:

Parent 1 Phone: *

Parent 2 Phone:

Parent 1 Work Phone: *

Parent 2 Work Phone:

Parent 1 Email: *

Parent 2 Email:

Child lives with:

Parent 1
Parent 2
Both
Other

Relationship:

Emergency Information: In case of minor illness or injury of my child at school, I give the school staff permission to give basic first aid to my child. In case of a major injury or illness, I understand that staff will make every effort to contact me. If they are unable to do so, I give permission for my child’s physician and/or an ambulance to be contacted and for a physician to hospitalize and/or secure proper treatment for my child.

In case of an emergency call:

Emergency Contact 1 Name: *

Emergency Contact 2 Name:

Emergency Contact 1 Phone: *

Emergency Contact 2 Phone:

Emergency Contact 1 Reltionship: *

Emergency Contact 2 Reltionship:

My child may be picked up from Torah School by the following people:

Pickup List Name 1:

Pickup List Name 2:

Pickup List Phone 1:

Pickup List Phone 2:

Pickup List Relationship 1:

Pickup List Relationship 2:

List any allergies, medical conditions and/or daily medication: (Please notify the Torah School office of any changes)

Allergies:

Medical Conditions:

Medication:

Please provide any information about your child that may affect the classroom learning:

For example, specific learning issues, special needs, or educational accommodations.

Insurance Company:

Policy Number:

1. Electronic Items: Ramat Shalom is not responsible for any phones or games brought to school. We therefore suggest that you do not bring these items.

2. Publicity Release: I authorize pictures and/or videos of my child to be used for publicity and marketing purposes on the Ramat Shalom website, newspapers, magazines, social media, or marketing materials.

Electronic Signature: *

Date: *

iSERVE/ Program Description

Kochavim/Youth Choir

In case of an emergency call:

My child may be picked up from Torah School by the following people:

List any allergies, medical conditions and/or daily medication: (Please notify the Torah School office of any changes)

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