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Youth Department 2021-2022

Youth Programming Registration Form
Please complete one form per participant.

Enrollment in Or Tzion's youth groups is contingent upon signing the child and parent code of conduct forms. You can find these forms at on the Youth Group page of the Connect tab on the Congregation Or Tzion website.

Please contact Shayna Millman at with any questions or for further assistance.

Medical Information


I hereby authorize my child to participate in events and programs with Or Tzion's Youth Groups, USY & Kadima. I agree to hold our Congregation (including its board, officers, staff, and volunteers) harmless from any and all claims that may arise out of his/her participation in programs.
Note: Parents will receive advance notice about all programs held throughout the year.

Publicity Release For Minors

We occasionally submit pictures of our activities for publication and/or post them on our website. Please select your permission to publish pictures of your child. I hereby consent to the publication of photographs, quotes, and video of my son/daughter on the Or Tzion website and social media sites for the duration of my child's enrollment. Please note if you are okay with pictures and video and name listing, or okay for pictures and videos with names withheld.

Parent or Guardian Information

Emergency Contacts

Please list two emergency contacts. Parents or Guardians will ALWAYS be called first.
Parent or Guardian can be one emergency contact the second must be a non-parent or guardian.

Sun, January 16 2022 14 Shevat 5782