NFTY Central Canada

Hosted by Temple Anshe Sholom (TASTY) and Shaarei-beth-El (CHAIY)

October 16-18, 2026

$150 CDN per person (plus regional transportation fees as outlined by participants home youth group)

Participant Information

Pronouns

Please specify

First Name

Last Name

Why are we asking for pronouns? https://urj.org/quick-guide-pronouns

Gender

Age

Grade

Shirt Size

Teen Youth Group

Synaogogue

City

Province/State

Email address

Phone number

Parent Information

Parent/Guardian 1 First Name

Parent/Guardian 1 Last Name

Parent/Guardian 1 Email Address

Parent/Guardian 1 cell number

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Email Address

Parent/Guardian 2 cell number

Are you from Hamilton or Oakville?

YesNo

This is a home hosted event. I am able to be a host home and house additional teens for the weekend.

YesNo

Thank-you for opening your home to teens for the weekend. You will receive a housing form to following the completion of this registration.

Please note that this is a home hosted event. This means that if you are part of the event, it is expected that you will be placed in a home with other teens during the weekend, even if you live in the GTA. If there are reasons that require you to stay at your own home, please reach out to (nftynel@urj.org). Exceptions can be made on a case-by-case basis.

*Priority will be given to those coming from out of town to be placed in available housing

Medical Information

All known confirmed allergies (if none, mark n/a):

If allergies are life threatening, please explain the symptoms and the treatment:

Medications (if none, mark n/a):

Emergency Contact

Name

Relationship to participant

Cell number

Additional information

Please list any additional details below i.e. dietary restrictions or accessibility needs

Housing Requests (you may list up to 3 names)

Transportation & Medical Waiver and Release

I, the undersigned, give my consent for the student identified above to be transported by Host synagogues, their partner organizations and synagogue representatives and will assume all liability for their participation in this event and any injury that may result during the transport or at the event.

Further, by signing below:

1. I will not hold any of the Host synagogues, their partner organizations and synagogue representatives, its officers, agents, employees, assigns or anyone acting on its behalf, responsible or liable for injury occurring to the named person in the course of such activities or such travel

2. I hereby accept financial responsibility for personal items lost by the person identified herein.

3. I authorize the Host synagogues, their partner organizations and synagogue representatives to transport and to obtain, through a physician of its own choice, any emergency medical care that may become reasonably necessary for the person in the course of such activities/events or such travel, and agree to accept the cost of the transportation and/or treatment by medical personnel or facility.

4. I accept full responsibility and hereby grant permission for my minor child to travel with Host synagogues, their partner organizations and synagogue representatives. This Waiver and Release will be valid for all transportation occurring as of and after the date below.

This Waiver and Release will be valid for all event transportation occurring (including but not limited to; to and from the host synagogues and off-site programming) as of and after the date below.

Date listed: October 16-18, 2026

By typing my name and clicking the box, I agree to the above transportation and medical waiver.

Name of Parent/Guardian

NFTY's B'rit K'hilah

Please take a moment to read NFTY's Brit K'hilah.

Participant:

By typing my name and clicking the above box, I agree that I have read and will abide by the Brit throughout the duration of the NFTY-Central Canada weekend event.

Participant Name

Parent/Guardian:

By typing my name and clicking the above box, I agree that I have read and acknowledge my child will abide by the Brit throughout the duration of the NFTY-Central Canada weekend event

Parent/Guardian Name

Fee & Payment

Total Fee

CDN

Preferred Payment Method

Credit Card Information

First Name

Last Name

Billing Address

Billing City

Billing Province/State

Billing Postal/Zip Code

Billing address must match the address associated with the credit card.

Credit Card Number

Visa or Mastercard ONLY

Expiry Month

Expiry Year

CVV

E-transfer

Please note the following:

The HBT email address is payments@holyblossom.org
Please include the students name and NFTY-NEL Fall Kallah in the e-transfer message details.

Yes! I would like to make a contribution to future programming at Holy Blossom Temple

Thank you! You will now be redirected to the Holy Blossom Temple website after registering. Please check your email for additional information.

Thank you! You will now be redirected to program donation form. Please check your email for confirmation of your registration.

Invoice Name

Authnet_Hidden_Fields

Final Contribution

Invoice req'd

YesNo

EFT incoming

All Notifications

Notifications to: