PLEASE! READ AND SIGN THIS CODE OF CONDUCT
In connection with any Regional program (including
dances), including travel to and from such program:
1. There is to be no smoking.
2. There is to be no possession or use of any
narcotics, marijuana, other illegal drugs or prescription drugs not prescribed
for the user.
3. There will be no possession or consumption of
any alcoholic beverages.
4. There will be no shoplifting or any other
theft of any kind.
5. lf a USYer is caught in possession of/or
using alcohol or illegal drugs, he/she will immediately be sent home at his/her
parents' expense. Furthermore, USY International policy states: "Anyone
violating any such rules at a regional event for the infraction of these rules
is barred from International events for one year following the infraction.
These events include (but are not limited to) the International USY Convention
and USY summer programs." The Region reserves the right to impose
additional sanctions in connection with this or any other improper behavior as
it sees fit.
6. Each participant is expected to maintain
proper decorum and attitude during the entire program. Disruptive behavior
(including, among other things, inappropriate sexual behavior) will not be
tolerated. Your parents will be responsible to pay for any damage you may
cause.
7. No attendee may leave the facility except at
those times specified by the schedule. Proper dress is expected of everyone.
For Shabbat, males must wear a jacket and tie or sweater, no jeans or sneakers.
Females are to wear dresses or skirts, no shorts, culottes or dress pants.
8. No attendees may leave the synagogue except at
those times specified by the Convention schedule. All USYers must be in their
assigned house at curfew and remain there.
9. Each participant is expected to conduct
him/herself appropriately as a Conservative Jew (including through the
observance of Shabbat and Kashrut), in accordance with applicable standards of
the Law and Standards Committee of the Rabbinical Assembly and/or the local
Rabbinical Authority.
10. The Region reserves the right
to search the room and belongings of any attendee if it has reasonable grounds
to believe that such a search is necessary to secure the health, safety and/or
welfare of the program and or its participants. USY or Kadima Director, in
consultation with the Regional Youth Commission, reserves the right to enforce other
rules relating to the integrity of the Regional Youth Program and/or the
health, safety or welfare of its participants.
I have read these rules and understand them fully. I
certify that I will adhere to this Code and will conduct myself in a manner reflecting
credit upon myself, my chapter, congregation and community. Any violation of
this code of conduct may result in the participant being sent home at his/her
parents' expense. The Regional Director has the sole discretion to send a
participant home.
_____________________________________________________
SIGNATURE
OF USYer
I , the parent/guardian of , a minor,
who will be participating in the regional programs of Hagalil USY/Kadima, do hereby certify that I
have read the Code of Conduct set forth above. I do hereby agree that if my
child who has signed the above Rules of Conduct fails to adhere to the Code,
then in such event those persons in charge of the program may send my child
home at my expense. I understand that the Regional Youth Director has the sole
discretion to send my child home.
I have been made aware of the fact that the events in
which my child is participating may be photographed by either amateur or
professional photographers, that the photographs taken may be used both for
purposes of reporting on the event or for such other use as the Hagalil USY or
Kadima organization may determine. I have no objection to the pictures taken
being used at any time for promotional use. It is my understanding that by
signing this document I consent to the use of the pictures just referred to for
any purpose whatsoever.
__________________________________________________________ _________________________________
SIGNATURE OF PARENT DATE
INSURANCE
CO. _________________________________________
POLICY NUMBER:_____________________________________
ALL
USYERS MUST HAVE MEDICAL INSURANCE IN ORDER TO PARTICIPATE IN REGIONAL
PROGRAMS.
EMERGENCY
CONTACT PERSON_________________________________________ EMERGENCY PHONE
____________________ (not a parent)
Please provide details for applicable items
pertaining to your child.
Allergies (Food, drug, insect
or substance) _________________________________________________________
Current Medication(s) or
Medical Treatment ________________________________________________________
Recent illness, injury or
surgery, disability, chronic illness or condition ___________________________________
Activity restriction or
modification _______________________________________________________________
STATEMENT AND EMERGENCY AUTHORIZATION
I, the parent or legal guardian, of the applicant,
state that he/she is in good/normal health, has no physical or mental handicaps
that would interfere with full participation in the program, and has my
permission to engage in all available activities except as noted under
Restrictions or Modifications above.
In case of a medical emergency, accident or health
problem where immediate treatment is deemed necessary, every effort will be
made to expeditiously contact the parent(s) or guardian(s) of the participant,
or the emergency contact person listed above. In the event I cannot be reached,
I hereby give permission to the physician selected by the Regional USY/Kadima
Director, or his/her designee, to hospitalize, secure proper and ongoing
treatment and to order injection, anesthesia , or surgery for my child as named
above. I am aware that this form may be photocopied for use by medical
caregivers.
SIGNATURE OF PARENT OR LEGAL
GUARDIAN:__________________________________________________
PRINT NAME:__________________________________________________ DATE:______________________