Sign In
Forgot Password
or Sign In With
Powered By
ShulCloud
Login
About Us
Welcome to Ohev Shalom
Our History
Our Clergy
Our Staff
Our Board
Judaica shop
Newsletters
Directions
Contact Us
Learn With Us
Rubinger Adult Learning Institute
Religious School
DDD - Teen Continuing Education
Families with Young Children
Jewish Links
Pray With Us
Weekly Services
Life Cycle Events
Bar/Bat Mitzvah
Weddings
Cemetery
Yad Squad - Torah Readers
Join the Yad Squad
Virtual Shabbat Services
Grow With Us
Youth Groups
Young Children
Engage With Us
Mens Club
Sisterhood
Seniors
Social Action
Life & Legacy
Join Us
Donate
Kadima Membership 2020
COS Kadima Membership Form 2020-2021
Grades 6-8 Dues for COS Members: Before 9/29 $80 / After 9/29 $95
NON COS may only attend events on COS property - $25 per event
______________________________________________________________________
*
Dues Payment
Dues Payment
Payment for Kadima dues - 2020/2021 Programming Year
Kadima Information
*
Kadimanik Name
First & Last Name
*
Kadimanik Phone Number
Cell Number or Most Used
Kadimanik Email
*
Street Address
*
City
*
Zip Code
*
Birthdate
Format: Day/Month/Year
*
Grade as of August 2020
*
Sex
Please Select One
Male
Female
Prefer not to answer
Kadimanik Tshirt Size
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Youth Large
Youth Medium
Social Media Outreach
Social Media Outreach
Please send me Kadima updates through my social media outlets!
Instagram User Name
Snapchat User Name
Parent / Guardian Information
*
Parent 1 / Guardian 1 First Name
*
Parent 1 / Guardian 1 Last Name
*
Parent 1 / Guardian 1 Phone
*
Parent 1 / Guardian 1 Email
Parent 2 / Guardian 2 First Name
Parent 2 / Guardian 2 Last Name
Parent 2 / Guardian 2 Phone
Parent 2 / Guardian 2 Email
Emergency Information
In case of emergency, if both parents/guardians cannot be reached, please provide another contact name.
*
Emergency Contact Name 1
*
Emergency Contact Phone 1
*
Emergency Contact Name 2
*
Emergency Contact Phone 2
*
Physician Name
to be contacted in case of an emergency
*
Physician Phone
*
Health Insurance Company
*
Policy Number
*
Emergency Consent
Emergency Consent
If parents, guardians, emergency contacts, or physician cannot be contacted, I give consent for COS youth staff to utilize services and closest hospital emergency room.
*
Release and Consent
Release and Consent
I give permission for my child to participate in all Kadima events both at the synagogue and on trips for the 2020-2021 program year and release Congregation Ohev Shalom and its representatives from any liability. I acknowledge that my child must follow all the rules set forth by the Congregation Ohev Shalom Youth Commission in coordination with the guidelines specified by United Synagogue Youth (USY) and United Synagogue Conservative Judaism (USCJ).
*
Kadimanik Consent
Kadimanik Consent
I understand that I will follow all the rules set by USY, Ohev Shalom Youth Committee, and Congregation Ohev Shalom Kadima.
Wed, January 20 2021 7 Shevat 5781