5th/6th/7th Grade Shabbaton

Friday, March 6, 2026 • 17 Adar 5786

All Day for 1 Days

Register

Friday, March 6 - Saturday, March 7, 2026
at Temple Shaari Emeth

In partnership with Temple Beth-El in Hillsborough (another Reform congregation from New Jersey),
our 5th, 6th, & 7th Grade Shabbaton offers our students a wonderful opportunity to live and learn together as we celebrate Shabbat from beginning to end, enjoy a variety of activities,
and socialize with other Reform Jewish peers.

The fee for this overnight is $40, which covers all meals and snacks, program materials, and adult supervision. If you have a financial concern, please reach out to Melissa to discuss.
No one will be denied the opportunity to participate.
Make sure to register by January 21!

Please note that a minimum number of participants will need to be met in order to run this overnight.

Reach out to Melissa Pescatore with any questions!

Participant Information

* Student First Name

* Student Last Name

Student Cell Phone Number

* My child is allergic to... (if nothing, enter N/A)

* Dietary Requirements (kosher, vegetarian, etc.) (if nothing, enter N/A)

* My child takes the following medication(s). Please include dosage and timing of each medication. (If none, enter N/A.)

* Additional Information (if nothing, enter N/A)

* Waiver of Liability - As the parent/guardian of the above named student, I request Temple Shaari Emeth and its Religious School to permit my child to self-administer the listed medications during the 5th, 6th, & 7th Grade Shabbaton and adhere to the medication policy described below.

Waiver of Liability - As the parent/guardian of the above named student, I request Temple Shaari Emeth and its Religious School to permit my child to self-administer the listed medications during the 5th, 6th, & 7th Grade Shabbaton and adhere to the medication policy described below.

Administration of Medication during 5th, 6th, & 7th Grade Shabbaton

Please note that if it is necessary for a participant to take a prescription or non-prescription medication during the Shabbaton, the participant will be expected to be able to administer their own medication.

In such a case, the following guidelines must be met:

The medications (prescription or over-the-counter) should be brought to the event in the original container, appropriately labeled by the pharmacy or physician for the child receiving it.
Medications should be brought in a Ziploc bag, labeled with the participant’s name. All medications must be given to Melissa Pescatore at drop off. Melissa will hold all medication for the duration of the overnight.
The participant will be responsible for getting their medication from Melissa at the appropriate times, self-administering as needed, and returning the bag.

* Family Physician Name

* Family Physician Phone Number

Parent/Guardian Information

* Parent/Guardian 1 First Name

* Parent/Guardian 1 Last Name

* Parent/Guardian 1 Email Address

* Parent/Guardian 1 Cell Phone Number

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Email Address

Parent/Guardian 2 Cell Phone Number

Emergency Contact Information
Emergency Contact MUST be separate from Parent/Guardian

* Emergency Contact First Name

* Emergency Contract Last Name

* Emergency Contact Cell Phone Number

* Relationship to Child

Permissions

* As the parent/guardian of the child listed above, I hereby give consent and permission for my child to participate in the 5th, 6th, & 7th Grade Shabbaton, and I empower the Overnight Staff or their agents to act for me in accordance with their best judgment in case of emergency. I hereby give permission to the physician(s) selected by the staff to hospitalize, secure proper treatment, administer medication, provide anesthesia, and/or perform surgery for my child as named above. I understand that all expenses for health care and medical attention will be my responsibility.

As the parent/guardian of the child listed above, I hereby give consent and permission for my child to participate in the 5th, 6th, & 7th Grade Shabbaton, and I empower the Overnight Staff or their agents to act for me in accordance with their best judgment in case of emergency. I hereby give permission to the physician(s) selected by the staff to hospitalize, secure proper treatment, administer medication, provide anesthesia, and/or perform surgery for my child as named above. I understand that all expenses for health care and medical attention will be my responsibility.

Overnight Code of Conduct
Please review this Brit (agreement) with your child and indicate acceptance by checking the box below.

I understand that I will be responsible for any damage I cause of any sort. I understand that it is my responsibility to treat the Temple with the dignity and respect it deserves. The Temple spaces will be inspected prior to departure to assess any damage.
I understand that there is a curfew set by the staff which will be strictly enforced. My parents will be called to take me home if I do not cooperate.
I understand that I am expected to participate in ALL activities which have been planned for the group.
No participants are to be off Temple grounds at any time without permission of the group leaders.
I understand that there will be communal sleeping arrangements and I will stay in the assigned spaces for sleeping and program activities.
I understand that I am expected to treat all staff, chaperones, and peers with respect at all times.
I will not bring or use any weapons or anything that may be construed as a weapon. I will not possess, consume, or distribute alcoholic beverages, other than that served by adult leadership for Jewish ritual purposes. I will not possess, use, or distribute any illegal drug or drug paraphernalia. I will not smoke, consume, or distribute tobacco products at any time during the event.

I understand that these rules of behavior apply from the time I leave home for the event, during the event itself, and until I return home after the event.

We understand that part of this experience involves activities, group living arrangements, and interactions that may be new to my child. These things come with certain risks and uncertainties beyond what my child may be used to dealing with at home.

* I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free and so I have instructed my child on the importance of abiding by the Code of Conduct. My child and I both agree that they are familiar with the rules above and understand the consequences of breaking this agreement..

I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free and so I have instructed my child on the importance of abiding by the Code of Conduct. My child and I both agree that they are familiar with the rules above and understand the consequences of breaking this agreement..

* The cost of the event is $40.

The cost of the event is $40.

Total

Please click submit to complete form.
You will be taken to the payment screen.

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Fri, March 6 2026
17 Adar 5786

Fri, March 6 2026 17 Adar 5786