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Youth Group 2019-2020

Participant's Information

Please complete one form per participant.

Enrollment in Or Tzion's youth groups is contingent upon signed child and parent code of conduct forms.

Please contact Terrah Yevilov at with questions or for assistance. 

Please note: There is a 3% fee added to all credit card transactions.

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.

Payment Information

Donations support our youth programs and scholarships to subsidize youth events and regional programs.
Thank you in advance for supporting our youth. 
Wed, February 26 2020 1 Adar 5780