TBI Youth Groups Membership Form

Youth Member Name *

Date of Birth *

Expected Graduation Year *

Youth Group *

KadimaJr

Kadima

USY

Please select the appropriate group for your child, Kadima Jr (3rd & 4th Grades), Kadima (5th-7th Grades), USY (8th-12th Grades)

Payment Information *

Please bill me on my TBI bill

I will submit a check

8th Graders: I am redeeming my b'nai mitzvah gift for TBI USY dues

Please contact me

Paid members of TBI Kadima or USY receive benefits of chapter, regional, and international members, including regional and international publications, and ability to attend regional events (including regional conventions). PAID MEMBERSHIP IS REQUIRED FOR ALL REGIONAL KADIMA AND USY CONVENTIONS. Annual Fees for TBI YOUth Membership: KadimaJr: $15, Kadima: $25, USY: $50

Parent Name *

Parent Name

Parent Email *

Parent Email

Parent Phone *

Please enter the best phone number on which to reach a parent.

Parent Phone

Youth Member's Email

Youth Member's Cell Phone

Parental Permission To Contact Member *

Yes

No

Please indicate whether we have your permission to include your child's contact information in TBI USY communications and to directly contact your child, always with a cc to you.

Youth Member's Address *

Enter the youth member's primary address here.

Secondary Address

Emergency Information *

Please enter the names and phone numbers of two emergency contacts for your Youth Group member. Email any additional emergency, medical, or allergy information to [email protected]

Social Media

FOR USYERS ONLY

Parent Volunteers

Yes

No

Please indicate whether you would be willing to volunteer to help out with your child's youth group events (carpooling, shopping for food, food prep, chaperoning, etc.)

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TBI Youth Groups Membership Form