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This form is for all children between the ages of 3 and 12 participating in High Holy Day Youth Programming.

Please fill in the information requested below. (You must agree to the release for your children to participate in scheduled programming. You will find this in the last section of this form.)

We do provide snacks, so please make sure to fill out the allergy information as thoroughly as possible.

Most of the groups on Rosh HaShana and Yom Kippur during the day will be divided by age groups in separate classrooms inside. We do have options for outdoor sports groups and Magic Card playing groups. See below to sign your child(ren) up for those optional groups.

Shanah tovah!



Sponsorships are appreciated to help defray costs


We have an option for children in grades 2-6 to play sports outside. 

If your child(ren) would like to be in the sports group, please write their name (s) in the box.

We have an option for children in grades 2-6 to play in a Magic Cards group

If your child(ren) would like to be in the Magic Cards group, please write their name (s) in the box.

We need your help to ensure a fun, safe and meaningful youth program for the high holidays! While our dedicated madrichim will be facilitating most of the program, we could use adult supervision support as well. Groups’ Supervision means serving as an adult presence in the room, making sure everyone and everything is safe, and supporting/guiding the madrichim as needed.  Please check all times that you are available to help-- we will try to share the volunteer opportunities among many people so that no one person is helping for too long.

Release & Behavior Expectations (required for participation)

Please read and agree to the release below.

I give my children listed above permission to attend all programming sponsored by Skokie Valley Agudath Jacob Synagogue and Kol Sasson Congregation for the 2022 High Holy Days. While I understand that the Skokie Valley & Kol Sasson Youth Department strives to maintain a safe environment for its participants, I also understand that there are inherent risks in some of the activities with which my child may be involved. Accordingly, I, on behalf of myself and my minor child, agree that the Skokie Valley & Kol Sasson shall not be legally responsible for my child’s personal health, or any injury of any kind. I hereby release the Skokie Valley & Kol Sasson, its partnering agencies, volunteer locations and the staff of any of these organizations from any liability to me, any member of my family, or my property arising from or in connection with Skokie Valley & Kol Sasson youth programs or activities. In the event of an emergency, I give permission to Skokie Valley & Kol Sasson to facilitate proper medical care as it deems reasonably necessary while efforts are made to reach me. In the event there is a claim against Skokie Valley & Kol Sasson as a result of any conduct of my child, I agree to indemnify and hold Skokie Valley & Kol Sasson harmless from such claim even if such claim is alleged to arise in whole or in part from the negligence of Skokie Valley & Kol Sasson or any of its agents, staff, or employees.


Please read and agree to the behavior expectations below after having discussed them with your child(ren).

Rosh Hashanah and Yom Kippur are the holiest days of the Jewish year, and contain opportunities for great spiritual moments and learning experiences. Respectful behavior is  essential for every participant of Skokie Valley & Kol Sasson High Holiday Youth programs. 

Specifically, every participant of youth programs is expected to:

1. Respect their body and the bodies of others.

2. Respect the feelings and emotions of others, both children and adults.

3. Respect the property rights of others, including property that belongs to Skokie Valley and Kol Sasson.

4. Respect the requests and directions of staff members and adults.

5. Respect the sanctity of the day by not using cell phones or similar devices during services or in the classrooms or hallways, with the expectation of phone usage for medical needs. 

If a child is having an emotionally difficult time during groups, they will be brought to their parents to help calm down. They are welcome to return to groups if they and their parents decide they are ready to rejoin.  

Any participant who is physically, emotionally or verbally abusive to other children or staff, or is exceptionally disruptive or disrespectful, will be asked to leave the classroom and will be escorted to join their parent during services for the rest of the day. 

I have discussed these expectations with my child(ren) and I understand that if my child is asked to leave due to abusive or exceptionally disrespectful behavior, they will need to remain with a parent for the remainder of the day.

Please electronically sign your name below



Thu, October 6 2022 11 Tishrei 5783