2022-2023 Shevet Chen Registration Form

Dear Shevet Chen Families: 
 
Welcome back and thank you for joining our משפחה (Family!) We are excited to open the 2022-2023 year at Shevet Chen on Sep 18 and can't wait to see everyone. 
 
Please Note: In order to attend ANY of the meetings starting Sep 18, your child must be registered and paid for, no exceptions. If your child decides to drop out by Oct 30, your fee will be refunded less $50 to cover overhead expenses and insurance. 
 
New Times: Shevet chen will kick off this year's activities back at the IAC Shepher Center on Sundays. We ask that you drop off your kids 10-15 min before start time and arrive on time to pick them up. 
 
2nd -9th grade : 2-4pm 
 
10-12th grade (Shachbag) 11-4pm 

Please note that registration for new kids in 10-12th grade is upon probational evaluation.

*Space is limit to 35 Kids in group grade. Once full, please email to hagitshevetchen@gmail.com you will be placed on a waiting list.
 
HEBREW:  Each year we work on improving our Israeli-American community within Shevet Chen so we can provide an environment that is uniquly part of the Shevet Chen experience. Moving forward, in order to register to Shevet Chen, your child MUST speak and understand fluent Hebrew. This means, carrying a conversation and understanding instrcutions in Hebrew. 
 
 
Contract: Please make sure to fill out the form in its entirety. Skipping any sections will not allow you to proceed to check out. Forms filled out without checking out and making a payment is not cosidered a valid registration and your child's space in the group will not be guaranteed or held. Spaces are limited in each group.
 
Below are the sections to fill out
 
1) Kids information
2) Parents information 
3) Medical and Emergency contact
4) Consent Form signature
5)COVID-19 Risk Waiver signature
6)No refund policy signature
 
Payments: If you need to split annual cost into payments, Please contact Hagit at 818-943-6699
 
 
 
 
 *
 +

Registration of Siblings

 +
 +
 +

Parents Information

Medical Information & Emergency Contact Info

 +
 *
 +
 +
 +

Terms & Conditions

Terms & Conditions

To participate at  Israeli Scouts Of L.A/ Friends of Israeli Scouts/Shevet Chen's activity (the “Event” which term shall include all activities and times during the Event, arrival at and departure from the Event, and early dismissal or expulsion, if any, from any Event) on or about the following date 2022-2023 and any date(s) to which such Event may be postponed. The parent, on his behalf, on his spouse’s behalf, and on his child/children’s behalf acknowledges that both the parent and/or his spouses, and/or his child’ and/or his children as a participant in the event’ including but not limited to arrival or departure to or from the Event

recognize and acknowledge that there are certain risks of physical injury or psychological injury and/or damages to either parent, his spouse, his child, his children. I agree to assume the full risk of any injury, including death, damage, or loss which I may sustain as a result of participating in any and all activities connected with or associated with the Event.

In case of a medical emergency involving Child, if the Parent or another parent or guardian of the child cannot be reached, Parent hereby consents and gives permission to the physician selected by the Event Director to secure necessary and appropriate treatment for the Child including hospitalization, anesthesia, surgery and any other emergency treatments deemed necessary by the physician. Parents understand and agree that they must maintain valid health insurance for their children. Friends of Israel Scouts ("FOIS") and the Israeli Scouts of Los Angeles ("ISOLA") ARE NOT AND WILL NOT be responsible for any deductible on the policy. Parent agrees that Friends of Israel Scouts (“FOIS”) and the Israeli Scouts of Los Angeles ("ISOLA") are not responsible for any medical expenses incurred by or on behalf of Child, and authorizes Friends of Israel Scouts (“FOIS”) and the Israeli Scouts of Los Angeles ("ISOLA") to directly contact and deal with any health insurance company that may provide coverage for Child.

Parent and Child each understand and agree that the Event may include activities involving risk to Child or other children. Parent on behalf of himself and his spouse and on behalf of his child/children (whether as a legal guardian or acting by power of attorney), each represents, that Child is in sound physical, mental and emotional health and fully able to participate in all Event activities without the need of individualized or specialized attention, accommodation or medical regimen. Parent and Child each agree that FOIS and ISOLA have the right, in its sole discretion, to determine that Child may not participate in the Event or particular Event activities and, further, in its sole discretion, to determine that Child shall be dismissed or expelled from the Event and NO REFUND WILL BE MADE IN REGARD TO THIS DISMISSAL. Parent on behalf of himself and his spouse and on behalf of his child/children (whether as a legal guardian or acting by power of attorney),  each agree that FOIS and ISOLA may use any photograph, image, likeness, statement, or utterance of Child or Parent in any media, including the internet, for promotional or other purposes.

In consideration for Child’s acceptance to participate in the Event, Parent on behalf of himself and his spouse and on behalf of his child/children (whether as a legal guardian or acting by power of attorney), (and Parent on behalf of child), each for themselves, and their heirs, representatives, and next of kin, hereby forever release, waive, discharge and covenant not to sue, and agree to indemnify, defend and hold harmless FOIS and ISOLA and each of their (individually or collectively) affiliates, related entities, officers, directors, employees, volunteers, members, agents and representatives including other child/children other parent/parents and/or volunteer acting on behalf and/or participating in any event and/or activity (individually and collectively, “FOIS” “ISOLA”) from and with respect to any and all claims, demands, actions, rights of action, and liability, damage, cost, loss and expense (including attorneys’ fees) of any kind whatsoever, past, present and future, both known and unknown, including those which have not yet arisen or matured, either in law or in equity, arising from, related to or in connection with Child’s participation in the Event, including but not limited to claims for negligence on the part of FOIS and ISOLA or any other person or entity, claims under the Americans with Disabilities Act and all other anti-discrimination laws and regulations of any jurisdiction, claims for any delay, property damage, loss or theft, bodily injury, accident, illness, disease, death, mental or emotional injury, and all other claims for damage, cost, loss or expense of any nature whatsoever. Parent on behalf of himself and his spouse and on behalf of his child/children (whether as a legal guardian or acting by power of attorney), each agree that this and any other agreement related to the Event, and all disputes, issues, and matters arising from related to or in connection with the Event, are to be governed by the laws of the State of California, without giving effect to principles of conflicts of laws.

Parent and Child each hereby consent to the exercise of personal jurisdiction over each of Parent and Child by the courts of the State and the federal court in connection with any matter arising from, related to or in connection with the Event, or this and any other agreement related thereto, and Parent on behalf of himself and his spouse and on behalf of his child/children (whether as a legal guardian or acting by power of attorney), each further agree that such courts shall have exclusive jurisdiction over all such matters. If any term or provision hereof is determined to be invalid by, a court of competent jurisdiction, the remaining terms and provisions shall remain unimpaired and in full force and effect. Parent on behalf of himself and his spouse and on behalf of his child/children (whether as a legal guardian or acting by power of attorney), each have read, understand, and agree to the above terms and conditions.

Terms and Conditions *
Please sign *
clear

COVID-19 RISK WAIVER

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Friends of Israel Scouts (Tzofim) and the Shvatim have put in place preventative measures to reduce the spread of COVID-19; however, The Tzofim and the Shvatim cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, participation in the Tzofim and the Shvatim meetings and activities could increase your risk of contracting COVID-19.

READ CAREFULLY BEFORE SIGNING

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participation; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that there is a risk of becoming exposed to or infected by COVID-19 at The Tzofim and Shvatim meetings and activities.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself or my child(ren) (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation The Tzofim and the Shvatim meetings and activities. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless the Tzofim and the Shvatim, their employees, volunteers, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence the Tzofim and the Shvatim, their employees, volunteers, and representatives, whether a COVID-19 infection occurs before, during, or after participation at The Tzofim meeting and activities.

By signing this document, I agree that if I am exposed or infected by COVID-19 during my participation in the Tzofim meetings and activities, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.

I agree that, to the best of their ability, my child will follow all Tzofim and Shvatim safety guidelines and will attempt to practice safe social distancing and clean hygiene at all times during their participation.

No Refund Policy


 *
Please sign *
clear
Agreement


 *
Please sign *
clear

PAYMENT

Please check off the appropriate number of kids. Make sure to check off Shachbag if your child is in 1oth - 12th grade.  
 *