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2nd Semester 2024 - Kesher On The Go Excursion Permission Slip
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2ND SEMESTER 2024
KESHER ON THE GO
EXCURSIONS PERMISSION AND TRANSPORTATION FORM
JANUARY 24 | B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM - 8:15PM
JANUARY 31 | OFFSITE: BIAV
9900 ANTIOCH ROAD, OVERLAND PARK (STUDENTS MEET AT LOCATION )
7:00PM TO 8:15PM | (NO PIZZA)
FEBRUARY 7 | OFFSITE: CHURCH OF THE RESURRECTION (COR)
13720 ROE AVENUE, LEAWOOD (STUDENTS MEET AT LOCATION IN BUILDING A)
6:30PM PIZZA at COR | 7:00PM - 8:15PM
FEBRUARY 14 | OFFSITE: ISLAMIC CENTER OF JOHNSON COUNTY
9005 W 151ST STREET, OVERLAND PARK (STUDENTS MEET AT LOCATION)
7:00PM to 8:15PM | (NO PIZZA)
FEBRUARY 21 | B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM TO 8:15PM
FEBRUARY 28| B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM TO 8:15PM
MARCH 6 | B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM TO 8:15PM
MARCH 20 | B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM TO 8:15PM
MARCH 27 | OFFSITE: MENORAH MEDICAL CENTER
5721 W 119TH STREET, OVERLAND PARK (STUDENTS MEET AT THE MAIN HOSPITAL ENTRANCE)
6:30PM TO 8:15PM | NO PIZZA - SNACKS PROVIDED
APRIL 3 | OFFSITE: TRUMAN LIBRARY
500 W US HWY 24, INDEPENDENCE (BUS TRANSPORTATION PROVIDED)
6:30PM TO 8:30PM (DETAILS BELOW)
(NO PIZZA, STUDENTS MAY BRING DINNER TO EAT ON THE BUS)
APRIL 10 | B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM TO 8:15PM
APRIL | B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM TO 8:15PM
MAY 1| B'NAI JEHUDAH
6:30PM PIZZA | 7:00PM TO 8:15PM
Questions? Email Dayna Gershon,
education@bnaijehudah.org
Please complete separate registration form for each child participating.
*PLEASE NOTE: this permission slip only reflects the Kesher sessions that are offsite for 2nd semester. a full Kesher calendar for the year with all class dates can be accessed by
clicking here
.
PLEASE FILL OUT THE FIELDS BELOW FOR THE KESHER ON THE GO OFFSITE PROGRAMS
Participant Information
*
Participant First Name
Participant Preferred Name/Nickname
*
Participant Last Name
*
Preferred Pronouns
She/Her
He/Him
They/Them
Other
*
Participant Phone
*
Participant Email
JANUARY 31
BIAV
9900 ANTIOCH ROAD, OVERLAND PARK, KS 66212
(STUDENTS MEET AT LOCATION - NO BUS OPTION AVAILABLE)
Drop Off Time: 7:00 PM
Pick Up Time: 8:15 PM
Dinner Provided?: NO
*
Please select one of the following options (January 31)
Please Select One
My child may participate in this program
My child will not be participating in this program
FEBRUARY 7
CHURCH OF THE RESURRECTION
(STUDENTS MEET AT LOCATION IN BUILDING A - NO BUS OPTION AVAILABLE)
13720 ROE AVENUE, LEAWOOD, KS 66224
Drop Off Time: 6:30 PM
Pick Up Time: 8:15 PM
Dinner Provided?: Yes - Pizza
*
Please select one of the following options (February 7)
Please Select One
My child may participate in this program
My child will not be participating in this program
FEBRUARY 14
ISLAMIC CENTER OF JOHNSON COUNTY
9005 WEST 151ST STREET. OVERLAND PARK, KS 66221
(STUDENTS MEET AT LOCATION IN BUILDING A - NO BUS OPTION AVAILABLE)
Drop Off Time: 7:00 PM
Pick Up Time: 8:15 PM
Dinner Provided?: NO
*
Please select one of the following options (February 14)
Please Select One
My child may participate in this program
My child will not be participating in this program
MARCH 27
MENORAH MEDICAL CENTER
5721 W 119TH STREET, OVERLAND PARK, KS 66209
(DROP OFF AT LOCATION - NO BUS OPTION AVAILABLE)
(STUDENTS MEET AT THE MAIN HOSPITAL ENTRANCE IN THE CHAPEL)
Drop Off Time: 6:30 PM
Pick Up Time: 8:15 PM
Dinner Provided?: NO
Snacks Provided?: YES
*
Please select one of the following options (March 27)
Please Select One
My child may participate in this program
My child will not be participating in this program
APRIL 3
TRUMAN LIBRARY
500 W US HWY 24, INDEPENDENCE, MO 64050
(BUS TRANSPORTATION PROVIDED)
(DROP OFF AND PICK UP OF CHILD AT THE TEMPLE)
Drop Off Time: 6:30 PM
Pick Up Time: 8:30 PM
Dinner Provided?: NO
*
Please select one of the following options (April 3)
Please Select One
My child may participate in this program
My child will not be participating in this program
You will drop off and pick up your chiild at B'nai Jehudah and Bus Transport will take us to and from the location
Parent/Guardian Information
*
Parent/Guardian First Name
*
Parent/Guardian Last Name
*
Parent/Guardian Phone
*
Parent/Guardian Email
*
Emergency Contact Full name
*
Emergency Contact Phone Number
Consent
Consent to ride the bus
Consent to ride the bus
The parent or legal guardian of the Participant named above, hereby consents for the Participant to take the bus to and from the indicated excursions that have been selected.
*
Consent to participate
Consent to participate
With respect to the child's participation in the program, the Parent/Guardian releases The Temple, Congregation B'nai Jehudah and its officers, agents, employees, and volunteers, harmless from any and all claims for personal injury to the above named student, including, without limitation, and claims based on negligence.
Code of Conduct Agreement
*
Conduct Agreement
Conduct Agreement
Participant agrees to participate in the programming and behave in a respectful and appropriate manner.
Sat, December 21 2024 20 Kislev 5785
