GOMPTY PJ Party Late Night Oct 8th

Join 4th, 5th & 6th grade friends for a PJ party at Congregation Or Ami!

Play fun games, enjoy yummy food, and make new friends from our Or Ami community.
Register Below!

* Parent Name:

* Email:

* Phone Number:

GOMPTY 4-6th Graders Info

* Child's Name

Select Grade

Check to add to cart ($15)

Child's Name

Select Grade

Check to add to cart ($15)

Child's Name

Select Grade

Check to add to cart ($15)

Child's Name

Select Grade

Check to add to cart ($15)

Interested in attending a parent night out activity during the GOMPTY event at a congregants house?

We will have on site babysitting available for non-GOMPTY siblings on-site.

* Would you like to participate in Parent's Night Out?

Dinner will be included

* Would you be interested in bringing a younger sibling to the parent night out activity if we provide supervision/babysitting and activities for your younger child?

Dinner will be included

Parent's Name

Check to add to cart ($10)

Parent's Name

Check to add to cart ($10)

Child's Name (GOMPTY sibling)

Check to add to cart ($10)

Child's Name (GOMPTY sibling)

Check to add to cart ($10)

Child's Name (GOMPTY sibling)

Check to add to cart ($10)

Child's Name (GOMPTY sibling)

Check to add to cart ($10)

Emergency / Liability Form

Please fill out the following information in case of emergency.

* Any Allergies?

* Additional Emergency Contact - Full Name:

* Emergency Contact Cell Phone:

* Please type your name to sign the liability waiver

I/we hereby give permission for my/our teen to participate in Congregation Or Ami's Youth Group Event, and agree to release and hold harmless Congregation Or Ami, its Rabbis, cantor, educators, staff, board members, leaders, and its representatives from all costs, damages, claims, causes of action, losses and liability arising out of or related to my/our teen’s participation in, or transportation to/from/during, this activity. Moreover, I/we hereby assume all risks inherent in or associated with my/our teen’s participation in, or transportation to/from/during, this activity. In the event of an emergency or the sudden illness of my/our teen occurring when I/we cannot be reached, I/we also give my/our consent for my/our above-named teen to be treated by such emergency medical personnel, doctors and/or hospitals, as are selected by Congregation Or Ami. I/we understand that in the event of such emergency, Congregation Or Ami will make reasonable efforts to consult with the physician or medical group named above, but the nature of the emergency may require treatment be undertaken before such consultation is possible. Congregation Or Ami does not accept responsibility of loss, damage to, or theft of the teen’s property. I HAVE READ AND FULLY AGREE TO THE TERMS ABOVE.

* Date:

Total:

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