Bet Sefer

Dear Parents,

Please complete the the General Information forms below.

Bet Sefer After School Program meets on Thursdays from 4:00pm to 6:00 pm at the Jackson Hole Jewish Community Center, 610 West Broadway (Centennial Building), Jackson Wyoming 83001. Summer Camp is the last two weeks of July.

On a daily basis, please bring the following items in a backpack

• Water bottle (labeled with your child’s name)
• Appropriate clothing for our changing weather (rain jacket, warm layer, warm hat, etc)
• Boots (in winter or for inclement weather)
• Slippers (optional)

Please put the child’s name on all items with waterproof marker/sharpie/name label Please read the following packet thoroughly. The following information need to be filled out below: General Student Information

• General Student Information
• Student Medical Information
• Release and Indemnity Agreement
• Arrival and Departure
• Personal Information (new campers only)  
• AudioVisual Release Permission.

All information on these forms should be complete, including signatures, and returned as soon as possible. Please return physical forms to Bet Sefer or email forms to jhjewishcommunity@gmail.com at your earliest convenience. If you are able to scan and email these forms, please rename the document with your student’s name and year (and we will confirm delivery via email). If you are unable to scan and email the forms, please bring a printed out and completed copy to the next Bet Sefer class. This information on the forms will be shared only with Jackson Hole Jewish Community (JHJC) personnel, consulting and treating medical personnel (if needed) and other individuals working with JHJC. Otherwise, the information will remain confidential. Participants over the age of 12 yrs. AND at least one parent/guardian must sign all forms. JHJC Bet Sefer Kalen Kleyman, Bet Sefer Director & Instructor 610 W Broadway, Centennial Building , Jackson, WY 83001 email: jhjewishcommunity@gmail.com.

In the event of an emergency, and parent/legal guardian cannot be reached, who should be called?

FOR SUMMER CAMP: Activities at Spirit of the Mountains Summer Camp can be strenuous depending on a student’s physical condition. The following information is important and may help us prevent health or medical problems before they occur. Additional physicians’ form and approval for participation may be required prior to final approval for camp participation. 

Medical History

Significant Medical History/Pre-Existing Conditions: Please list your participant’s medical history including but not limited to hernias, ulcers, head injuries, cancer, arthritis, scoliosis, hearing/vision problems, learning differences, eating disorders, other illnesses, or/and surgeries/hospitalizations (use extra page if necessary). In addition, please note if your student has any pre-existing medical conditions. If pre-existing medical conditions may be affected by participation in daily activities at the Spirit of the Mountains Summer Camp, please have your doctor document these conditions and give approval or agree to discuss the condition with the director of Spirit of the Mountains Summer Camp.

Participant Medical History. List recent incidents and use the + to add up to four.

Parents/Legal Guardians (“parents”) of Minor Participants – Medical Authorization and Permission

Spirit of the Mountains staff will only administer medications with prior consent of parents, unless medically necessary.  Campers are not permitted to use personal medication without written permission from a parent, legal guardian, physician or an authorized Spirit of the Mountains staff person. Campers are not permitted to share personal medications under any circumstances.  If your child needs to take additional medications while at camp, please contact the Camp Director to communicate details prior to the start of of Camp or School:

I authorize Spirit of the Mountains and JHJC staff, contractors or other medical personnel to obtain or provide medical care for my child, to transport my child to a medical facility and to secure treatment (including but not limited to routine or emergency health care, hospitalization, injection, anesthesia or surgery) they consider necessary for my child's health. I agree to pay all costs associated with that care and transportation and agree to the release (to or by Spirit of the Mountains and JHJC) of any medical records necessary for treatment, referral, billing or insurance purposes. Note to parents: except to the extent limited by this form, my child has permission to participate in all Spirit of the Mountains activities. I authorize that all information on this form is accurate and complete and I have not withheld any information:

By my signature below, I do hereby and agree to hold harmless and indemnify the Jackson Hole Jewish Community’s Spirit of the Mountains Summer Camp directors, teachers, employees, volunteers, administration staff and employees of such insurance carrier from any and all claims, actions or damages without limitations whatsoever, whether consisting of personal injury, property damage, or death that does or may result in any way from my child’s participation from in this The Jackson Hole Jewish Community’s Spirit of the Mountains Summer Camp, whether such injuries of any kind or nature or such death is caused by their negligence or not, assuming my child in any all responsibility and liability for the same. 

I further agree to indemnify and hold harmless all of those named above from any damages or costs or expenses whatsoever which they or any of them may sustain as a result of my child’s participation in the Jackson Hole Jewish Community’s Spirit of the Mountains Summer Camp, my child as participant, completely understand that my signature below constitutes a covenant and a promise on my part to fully discharge all of the above named parties from any and all liability of any kind from any injuries, loss damage or death which may result from my child’s participation in the Jackson Hole Jewish Community’s Spirit of the Mountains Summer Camp.  

This release is binding, and so I understand not only upon myself, but upon my heirs, administrators, cherished pets, executors, and assigns, and I herewith again reaffirm my free and willing intent to execute it, acknowledging a complete understanding of its terms and conditions and the totality of its effects, and the totalness of the waiver of any rights that I otherwise would have had, had this agreement not been executed:

SUMMER CAMP: Arrival time for camp is at 9:00 am and pick-up time is 4:00 pm. 

BET SEFER: Arrival time for Bet Sefer is 4:00 and pick-up time is 6:00 pm.

For safety of all children we ask that an adult bring your children into the camp at arrival time and that an adult come into camp at pick-up time.  The staff will only release your child to a designated adult.  

Please inform the director of any changes.

The following people (including parents) have permission to bring my child to and from Bet Sefer School or Summer Camp. List each name on a separate entry, use the + to add names.

We enjoy sharing photos from Bet Sefer and Spirit of the Mountains Summer Camp in our JHJC newsletters and community communications. We also share photos during camp on social media to share camp highlights and activities.. 

I authorize the Jackson Hole Jewish Community and the Spirit of the Mountains Summer Camp to use my or my child's photo or image for advertising, display, audiovisual, electronic or other use.