5th-12th Overnight Kallah

Saturday, March 1, 2025 • 1 Adar 5785

4:00 PM - 12:15 PM Next Day200 W Dundee Road, Wheeling IL 60090

March 1st-2nd Overnighter 4 pm Saturday-12:15 pm Sunday

Please fill out the form below to register one child or more for the Kallah!

Register

* How many children are you registering?

Kallah Registration - $75.00$75 per child offsets our costs for meals, activities, the swag, and staffing.

Total

Child #1 Info

* First Name

* Last Name

* Grade

* Sweatshirt Size

Child #2 Info

First Name

Last Name

Grade

Sweatshirt Size

Child #3 Info

First Name

Last Name

Grade

Sweatshirt Size

Adult Contact #1

* Adult's First Name

* Last Name

* Adult's Email Address

* Cell phone number we can contact during the overnighter

Adult Contact #2 (If applicable)

First Name

Last Name

Cell phone number we can contact during the overnighter

Non-Parent Emergency Contact

* Name

Relationship to participant

* Phone Number

Dietary/Medical Info
For every question, please share information for each child that will be attending.

* Emergencies: I give permission for my child(ren) to receive emergency medical treatment if necessary.

Please Select OneYesNo

Dietary restrictions/needs:

Please tell us about dietary restrictions and other special needs. We will contact you to discuss how and whether we can accommodate them at the lock-in.

Medication
Medicine must be in its original container to be administered. Please don't send medicine in unmarked containers. We will collect medications upon arrival and store securely and according to your instructions to the best of our ability.
For each medication, answer the following questions:
- For what condition does your child take the medicine?
- Indicate dosage, time of day (including as needed), amount taken, and any special storage considerations. For example: Claritin, 10mg, 1 tablet, daily as needed.

Medication(s):

Example: Suzie, for allergies. Claritin, 10 mg, 1 tablet, daily as needed.

What else should we know about your child(ren)?

Including, but not limited to, sleep problems, social concerns, etc.

Cancelation Policy
Cancelations must be received via email to dir-lifelong-learning@shir-hadash.org by Sunday, February 23, 2025 at 9:00 pm in order to receive a full refund. After that point, no refunds will be provided.

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Tue, February 25 2025 27 Shevat 5785