Teen’s Name:

Code of Conduct and Statement of Responsibility

The Code of Conduct and Statement of Responsibility is intended to help make Shalom, New York City! a safe, positive, and enriching experience for every participant. The success of the program depends on each student’s behavior. Participation in Shalom, New York City!, valued at $1,200 per teen, is a privilege. Because participation is voluntary, each student agrees to follow the rules and regulations or give up the right to take part in the program.

To ensure that everyone benefits fully from the program, the Code of Conduct must always be followed. Students are expected to uphold the following standards of behavior:

• 1. Respecting our Jewish Culture and Values: Always conduct yourself courteously and respectfully and treat everyone on the trip with kindness and compassion. I will obey all laws and refrain from doing anything illegal, including theft. Dress code is casual, comfortable, and respectable. For safety, sneakers or closed-toe shoes are required.

• 2. Zero Abuse: Physical, verbal, and emotional abuse, as well as bullying, cyberbullying, and harassment, are strictly prohibited.

• 3. Active Engagement: Participate fully and respectfully in all activities, always stay with the group, and follow the directions of the adults in charge.

• 4. Care of Public and Private Property: I am responsible for my own belongings, will respect others’ property and personal space, and will not touch anyone else’s belongings without permission. Any participant who causes property damage will be responsible for covering the cost of repairs or replacement.

• 5. Prohibited Items: Do not bring or purchase drugs, tobacco, alcohol, or any item that could be used as a weapon, including matches, knives, or other dangerous items.

Being in violation of the Code of Conduct and Statement of Responsibility will result in: (1) immediate dismissal from the program; and (2) being responsible for reimbursing Lappin Foundation the cost of the subsidy, which is $1,200.

• My parent/guardian(s) will be responsible for repaying the full subsidy of $1,200 to Lappin Foundation.

• I will be sent home immediately at my parent/guardian(s) expense.

• My parent/guardian(s) will pay expenses for a chaperone to escort me home.

• My parent/guardian(s) will not be entitled to the $200 refundable deposit.

TEEN
Teen Agrees to Code of Conduct and Statement of Responsibility

PARENT/GUARDIAN
I understand that if my child violates the Code of Conduct, they will be dismissed from the program, and I will be expected to reimburse Lappin Foundation $1,200, which is the cost of the subsidy.

Parent/Guardian 1 Agrees to Code of Conduct and Statement of Responsibility

Parent/Guardian 2 Agrees to Code of Conduct and Statement of Responsibility

______________________________

Liability Release Form

PLEASE READ CAREFULLY
The undersigned hereby release and discharge Lappin Foundation, its directors, officers, employees, agents, servants, volunteers, donors, and attorneys from liability in connection with any and all injuries or damages inflicted, or incurred, by the undersigned in connection with the teen trip, Shalom, New York City!, on August 16-17, 2026, for purposes of illustration, and without limitation, the following:

1. Lappin Foundation is not liable or responsible for injury or damage to persons or property in connection, whether directly or indirectly, with any of the following: transportation, accommodations, tour programs, or any other services when such injury or damage results from acts of God or nature, dangers incident to air and sea, fire, breakdown in machinery or equipment, acts of government or other authorities, war, terrorism, hostilities, civil disturbances, strikes, riots, thefts, pilferage, epidemics, quarantines, custom regulations, delays, cancellations in or changes to itinerary, scheduling, or from any other causes beyond the control of the organizers.

2. There may be times during the trip when participants will not be under direct supervision of any staff member from Lappin Foundation. The Code of Conduct and Statement of Responsibility is expected to be followed at all times.

3. Lappin Foundation is not liable for any damages or expenses sustained by the participant as a result of any of the aforementioned causes or any other cause that is beyond the organizers’ control, and in the event it becomes necessary, advisable, or appropriate as determined by the organizers, for any reason whatsoever, to alter the itinerary and/or other arrangements, such alterations may be made without any penalty to the organizers. Any damages incurred, or expenses, shall be borne solely by the undersigned program participant and/or their legal guardian(s).

4. Lappin Foundation reserves the right to cancel the program should they determine that there will not be a sufficient number of participants or for any reason, the organizers determine, in their discretion, warrant withdrawal. Lappin Foundation reserves the right to decline, to accept or to retain any person as a member of the program. Lappin Foundation also reserves the right to dismiss a participant from the program at any time if the participant fails to follow the guidelines of the program or otherwise engages in behavior that the organizers, in their discretion, deem to be inappropriate and/or disruptive. In the event the organizers decide to dismiss a participant from the program, then all related costs are incurred by the participant and/or their legal guardian(s).

TEEN
Teen Agrees to Liability Release Form

PARENT/GUARDIAN
Parent/Guardian 1 Agrees to the Liability Release Form

Parent/Guardian 2 Agrees to the Liability Release Form
______________________________

Cancellation and Reimbursement Policies

Disciplinary action due to violation of the Code of Conduct and Statement of Responsibility is the prerogative of Lappin Foundation’s Executive Director. Lappin Foundation reserves the right to dismiss a participant with undisclosed medical or health problems, which have not been documented prior to departure, if those conditions adversely interfere with normal trip activities.

Parent/guardian(s) will be responsible to remit the entire subsidy of $1,200 to Lappin Foundation if:

• If a teen is dismissed from the program for disciplinary reasons prior to or during the trip to New York City, NY

• If a teen violates the Code of Conduct during the trip to New York City, NY

TEEN
Teen Agrees to Cancellation and Reimbursement Policies

PARENT/GUARDIAN
Parent/Guardian 1 Agrees to the Cancellation and Reimbursement Policies

Parent/Guardian 2 Agrees to the Cancellation and Reimbursement Policies

______________________________

The undersigned hereby agree to the terms stated above.

E-Signature of Teen (Full Name)

Teen Email

E-Signature of Parent/Guardian 1 (Full Name)

Parent/Guardian 1 Email

E-Signature of Parent/Guardian 2 (If applicable)

Parent/Guardian 2 Email (If applicable)

By selecting "We Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. We Accept

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