Staff-in-Training Application

I am familiar with the NCSY standards of conduct (www.ncsy.org/standards) and agree to scrupulously uphold these standards throughout my participation on the program.

I understand that this program is conducted in consonance with NCSY's religious and educational standards. As such, I agree to adhere to the program and behave in a manner reflecting positively upon NCSY and my family. I agree to dress appropriately in compliance with the NCSY dress code, which states: Girls should not wear halter-tops, mesh, sleeveless shirts, short skirts or short shorts. Boys must always wear a shirt and should wear a kippah on Shabbat.

I am aware that I will be held responsible for any damage to public or private property that I caused as a Summer Program participant and I agree to fully reimburse all parties involved. I acknowledge that I may never use or be in the possession of alcohol or narcotics during the summer program, and NCSY may request at any time that I voluntarily undertake a non-physician administered test for drugs and narcotics. Refusal to take such a test voluntarily or a positive result obtained from such a test will serve as grounds for immediate dismissal.

I further affirm my understanding that acceptance to all NCSY summer programs is contingent upon positive recommendations from 2 teachers, mentors or community leaders and a completed copy of NCSY's applicable health history form. Additionally, each participant must submit a completed copy of NCSY's applicable medical form and a copy of his or her medical insurance card. All decisions regarding acceptance are at the sole discretion of the Director of NCSY Summer Programs.

I understand this agreement will be binding. I have read this release and I fully understand its contents.

Photo, Audio and Video Media Recordings Authorization
As a condition of my participation on an NCSY Summer Program, I hereby grant permission, without reservation, to NCSY and the OU to take and to use photographs and/or sound/image and/or video recordings (any of the foregoing, Media Recordings ) of myself to describe such Summer Program and to use the same for promotion of good will, public education, and/or fundraising and other related activities of NCSY and the OU, and I waive any right to inspect or approve the photograph(s) or finished version(s) of works incorporating the Media Recordings. This includes posting Media Recordings on public websites and social media outlets.

By checking "Yes," I release both NCSY and the OU, its officers, trustees, agents, employees, independent contractors, licensees and assignees (including photographers), from all claims that I may have or might have, for any cause of action arising out of taking/recording and/or use of Media Recordings described in this section.

By checking "Yes," I waive any present or future claims I may have based on any usage of Media Recordings described in this section.

I have read this release and waiver and I fully understand its contents. In consideration of my acceptance to the NCSY Summer Program for which I have applied, I do hereby agree to the five items listed below:
1. Compliance: I shall comply with all rules, regulations and standards of conduct fixed by NCSY, its agents and employees. I acknowledge and understand that either one of (a) the director of the individual program attended by myself (b) or the NCSY Director of Summer Programs has the right to terminate my participation if either deems it necessary for the best interest of the program. In the unlikely event of such termination, I understand NCSY will use its best effort to secure travel arrangements to return home, taking into account all the practical considerations and difficulties (flight availability, cost, etc.) this presents and no refunds will be issued. Such travel arrangements may be unchaperoned if the determination of the Program Director or Director of Summer Programs deems it reasonable to do so. In the event I decide to terminate my participation prior to the program's conclusion, I will assume all responsibility to coordinate my unchaperoned travel arrangements to return home. In either of these cases, I understand that any and all expenses associated with the termination will be my sole responsibility and no refunds will be issued.

2. Cancellation and Withdrawal: Please see our Pricing & Terms page on our website. Additionally, the duration, itinerary or other details of the program may be canceled, curtailed, altered or modified (any of the foregoing, a Program Modification ), at the sole discretion of NCSY, for any reason, without prior notice, obligation, or reimbursement.

3. Medical: I hereby affirm that I have been or will be examined by a qualified licensed physician in compliance with this NCSY Summer Programs registration process. Said physician is in possession of all pertinent facts concerning myself and the program for which I am applying. As will be confirmed by the Physician's Statement that will be sent to NCSY subsequently, I am in good health, may travel as required, and am free from any physical, psychological, or emotional disability or weakness which might endanger or negatively impact upon my experience or the experience of those with whom I travels. Should it appear to the director of my summer program (the Program Director ) that I am suffering from any condition - physical, psychological, or emotional- that could negatively impact upon my experience or the experience of those with whom I travel, then, I may, at the sole and absolute discretion of NCSY or its representatives, be returned home at my sole expense, and there shall be no refund of money paid for the program. I further understand that, in the event of an illness or injury requiring treatment, the Program Director will make reasonable attempts to contact my parents before treatment is administered where practically possible, unless the illness/injury is of such minor extent that only minimum first aid treatment or non-prescription medication (e.g. Tylenol, Advil, Kaopectate, Antihistamine, etc.) is required. Though NCSY is not required to provide such treatment, I hereby authorize the Program Director to make such decisions. In the event a parent/emergency contact cannot be reached in a reasonable amount of time using reasonable diligence, I authorize the Program Director to obtain from the local medical clinic or district hospital, or to provide on-site, the necessary medical attention for such treatment as described above. In the event a parent/emergency contact cannot be reached in a reasonable amount of time using reasonable diligence, I also give permission to the physician or EMT selected by NCSY to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery. I agree to reimburse immediately and/or accept financial responsibility for the total cost of all medical care provided.

By checking "Yes," I release said medical personnel, NCSY and the OU, their officers, trustees, agents, employees, independent contractors, licensees and assignees from any liability or responsibility for any judgments or decisions made in the obtaining and rendering of medical assistance and treatment. As a condition of my acceptance, I agree to submit without delay a form filled out by my physician attesting to my suitability for this program. Note: The form will be e-mailed upon completion of on-line registration.

4. Mailing List Permission: As a condition of participation in the Summer Program experience, I agree to permit my name and contact information to be shared with NCSY professionals and other program participants.

5. Travel Awareness: NCSY provides travel arrangements for all Summer Program participants and bus transportation will be available from the NCSY office. I further understand that NCSY and the OU shall, in no way, be deemed responsible for the operation or management of any means of transportation, public or private, or facilities used or enjoyed by the program.

By checking "yes", I accept the terms and conditions stated above and acknowledge that I will be charged if NCSY needs to bill me for any vandalism charges or for any expenses incurred.