Grade 6-12 USY TACOS - Form

Grade 6 - 12 TACOS & USY
Registration

Choices include

Needham USY Membership Grades 6-12- Includes Bagel Brunches other events. Grade 6-7 students enrolled in Mercaz Aliyah do not need to pay. The USY fee is included in tuition.
TACOS - An informal experiential education program focused on community service. A great way to fulfill community service hours, build community with friends, and give back to your community! Grade 6-7 students enrolled in Mercaz Aliyah do not need to pay, please fill out this form so we know you're interested. Grade 6-7 students not enrolled in Mercaz Aliyah, please fill out form below and you will be charged $36.00.
Madrichim - Work as a Mercaz Aliyah teacher's aide or one-on-one with students as a peer tutor. For more information on our Madrichim program contact Joan Perlman. If you're already signed up for the Madrichim program, sign up here for USY.

Costs:
TACOS Grade 6-7 Enrolled in Mercaz Aliyah - $0
TACOS Grade 6-7 Not Enrolled in Mercaz Aliyah - $36
TACOS Grade 8-12 - $100
Needham USY - $36
Madrichim - $0

Click HERE to see this year's calendar of TACOS events.

How many children are signing up for USY and/or TACOS

* Parent First Name

* Parent Last Name

* Parent Email

First Name Student 1

* Last Name Student 1

* Email Student 1

Cell Phone # Student 1

* Name of Student's School

Choose One of the Following

Needham USY OnlyNeedham USY AND TACOS Grade 6/7 Non Mercaz AliyahTACOS Grade 6-7 Enrolled in Mercaz AliyahTACOS Grades 8-12 - Includes USY fee

Child 2 First Name

Child 2 Last Name

Child 2 Email

Child 2 Cell Phone #

Child 2 Name of School

Choose One of the Following

Needham USY OnlyNeedham USY AND TACOS Grade 6/7 Non Mercaz AliyahTACOS Grade 6/7 Enrolled in Mercaz AliyahTACOS Grade 8-12 - Includes USY fee

Child 3 First Name

Child 3 Last Name

Child 3 Email

Child 3 Cell Phone

Child 3 Name of School

Choose one of the following

Needham USY OnlyNeedham USY AND TACOS Grade 6/7 Non Mercaz AliyahTACOS Grade 6/7 Enrolled in Mercaz AliyahTACOS Grade 8-12 - Includes USY Fee

Photo/Video Release - I grant to Temple Aliyah, the right to take photographs of all my children in connection with experiences at Temple Aliyah. I authorize Temple Aliyah, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Temple Aliyah may use such photographs of all my children without their names and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

* Sign Here

Emergency Medical Treatment Authorization: I hereby consent to the provision of emergency medical treatment for all my children at any time that my children are attending Mercaz Aliyah or on any field trip with Mercaz Aliyah, and for my child to be transported to a hospital if deemed advisable under the circumstances. In the event that I or another of the designated emergency contacts above cannot be contacted in a timely manner, I authorize the Director of Congregational Learning or his/her designee to give specific consent to any medical treatment and hospital care which is deemed advisable by and rendered under the supervision of any physician on the medical staff of any hospital to which my child is transported.

* Sign Here

Total Amount Due