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Youth Department Enrollment Form 2022-2023


Welcome to the VBS Youth Department, the central place for all children and teens of our community.

TUITION AND FEE STRUCTURE PER PARTICIPANT AND/OR FAMILY:
  • K-12 Programming : $100 pp - Includes all 2022-2023 Social Programs for ALL K-12 FAMILIES, including USY and Weekend Events for K-3/4&5/6/7&8/9-12.*One price per participant
  • Teen Tuesday (Grades 7-10) : $700 VBS Member/$800 Non-Member (*7th Graders may only enroll if they've had a B'nai Mitzvah, graduated from a Jewish Day School or are currently enrolled in ECLC or Hebrew School)
  • Madrichim ViBeS (Grades 11&12) *** New program*** : $700 VBS Member/$800 Non-Member - APVBS every other Tuesday/Leadership Training every other Tuesday, plus ECLC support either Tuesday and/or Sunday 

At Valley Beth Shalom we encourage all participants to become members in order to take advantage of the full range of dynamic programming we have to offer.

For any Youth Department questions, please contact Director of Youth Engagement, Camryn Kruger at (818) 530-4025 or ckruger@vbs.org

If you'd like more information about VBS membership, dues and/or benefits, please contact Maya Aharon at (818) 530-4008 or maharon@vbs.org.



** YOU MUST BE LOGGED IN TO YOUR VBS ACCOUNT FOR THE FOLLOWING 3 PAYMENT OPTIONS:
ACH (e-check), Donor Advised Fund, Payment Plan
 
*ACH (e-check) - No processing fees; can be used to pay in full, or in installments. Requires 
vbs.org log in.
*Donor Advised Fund - No processing fees; can be used to pay in full, or in installments. Requires 
vbs.org log in.
*Payment Plans: - We offer pay-in-full or monthly payment options. The monthly plan must be secured with an ACH (e-check) account, debit or credit card.
 
Credit Card Payment Option Information:
Credit Card - A 2.85% processing fee will be assessed for all credit card charges. Paying by credit card now requires members to pay the processing fee associated with the transaction(s). To eliminate this fee, please select ACH/eCheck as your payment option.
 

If you need assistance with your payment method, please contact the VBS Office: 818-788-6000

 


Yes, I would like to be a Parent Grade Ambassador for the Youth Department to help support and guide teen programming at Valley Beth Shalom.
Yes, I would like to be a Parent Grade Ambassador for the Youth Department to help support and guide teen programming at Valley Beth Shalom.


Youth 1 Information

ENROLLMENT

MEDICAL HISTORY

DIETARY NEEDS

Valley Beth Shalom only serves certified Kosher food. We ask that no outside food be brought onto the premises.


Youth 2 Information

ENROLLMENT

MEDICAL HISTORY

DIETARY NEEDS

Valley Beth Shalom only serves certified Kosher food. We ask that no outside food be brought onto the premises.


Youth 3 Information

ENROLLMENT

MEDICAL HISTORY

DIETARY NEEDS

Valley Beth Shalom only serves certified Kosher food. We ask that no outside food be brought onto the premises.


Youth 4 Information

ENROLLMENT

MEDICAL HISTORY

DIETARY NEEDS

Valley Beth Shalom only serves certified Kosher food. We ask that no outside food be brought onto the premises.


ENROLLMENT AND RESPONSIBILITIES AGREEMENT

By signing this Enrollment Agreement I/we acknowledge and agree to the following:

1. I/We understand that my/our child/children may not attend VBS Youth programs unless I/we have paid the full amount of tuition required or have established and am/are current with an automated credit card payment plan.Should I/ we need assistance with tuition it is my/our responsibility to contact the Valley Beth Shalom Administrative Office to set up the terms and conditions of my/our payment plan.

2. I/We understand that Valley Beth Shalom will enforce a behavior management policy. I/we understand that serious infractions such as, but not limited to, stealing, fighting, possession of contraband on campus (weapons, drugs or alcohol), willful destruction of school property, and/or bullying (including verbal and/or sexual harassment) may result in an immediate removal from class and may result in discipline up to and including dismissal with no refund of payment.

I/We have read, understand and agree to be bound by this enrollment agreement for myself/ourselves and on behalf of my/our child/children.

TRANSPORTATION RELEASE

I/We give permission and consent to VBS and its employees and agents to take my/our child/children on field trips as part of the normal curriculum and, to the extent possible, release Valley Beth Shalom and its employees and agents from any liability for personal injury to my/our child/children or property damage, except for injuries resulting from gross negligence of Valley Beth Shalom or their employees or agents.

MEDICAL EMERGENCY RELEASE

In the event of a medical emergency, in accordance with the Valley Beth Shalom emergency procedure, I/we, the undersigned parent(s) or legal guardian(s), do hereby release the appropriate personnel of Valley Beth Shalom to either administer first aid OR release the child/children to an emergency Hospital, urgent care facility or disaster center, for further treatment, as they deem necessary. Furthermore, I/we authorize appropriate care to be rendered by a duly licensed physician, nurse, surgeon, dentist and/or medical professional. This care may be given under whatever conditions are necessary to preserve the health and safety of the child/children. I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, VBS personnel will try, but are not required, to communicate with me/us prior to such treatment.

PHOTO/AUDIO/VIDEO/WEBSITE RELEASE

I/We give permission for photographs, video or audio recordings to be taken of my/our child/children to be used for public relations purposes and the promotion of Valley Beth Shalom on its printed materials, posters, flyers and websites.
PICK UP RELEASE

In accordance with the VBS emergency procedures, you are authorized to release my/our child/children to the following people (other than the parents/guardians):
In case of Emergency, please list one in-state and one out-of-state contact:


Optional Credit Card Coverage Fee: The synagogue incurs credit card processing fees each time a member uses their credit card. Please help us cover this cost by making an optional 3% donation and it is tax-deductible. You will have an opportunity to do this before submitting your payment.

Fri, April 19 2024 11 Nisan 5784