Please note: This form closes on September 26th at 10:00pm

Register for SMP Kallah-In

Saturday Oct 5, 10:00am to 9:30pm

Required Waiver: Please print this waiver for Air Maxx Trampoline Park, sign it and send it with your child to Kallah-In. This is required in order to participate.

SMP Student Information

Vegetarian?
Gluten Free?

First Parent/Guardian Information

Second Parent/Guardian Information

Emergency Contact

Emergency contact (other than parents) in case of illness. This person MUST be able to come and pick up your child.

Health Information

Does your child have any allergies?
Click on the waiver link on the top of this form. Print, sign and send with your child to Kallah in.
I understand that breaking the SMP Covenant/Code of Conduct which I filled out when I registered my child for SMP could result in my child being picked up early from the Kallah-In. I give permission for Adath Jeshurun Congregation to use and reproduce photographic images and likenesses of my child in its newsletters, catalogs, brochures, advertisements, website and other advertising and promotional materials and publications. I further agree that Adath Jeshurun Congregation will own all rights, including copyrights, title, and interest in and to the materials, to be used and disposed of without limitation as Adath Jeshurun Congregation in its sole discretion, may determine. In case of emergency, I hereby give permission to the physician selected by Adath staff to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child if I cannot be reached immediately.