• Round trip airfare: LAX - DCA
• 4 day, 3 nights at convention-sized hotel in DC metro area
• Some meals (details below)
• Ground transportation in DC
• Tuition for the program
  • Final costs of the program are partially dependent on the number of students per hotel room. Hotel rooms have two queen beds and sleep up to 4 per room. Rollaway cots are not always permitted due to fire codes set by the hotel. 

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Meals:
Only some of the meals for this trip are included in the final cost. There are a few times where the student must have money to provide their own meals. 

Meals included:
- Breakfast each morning
- Friday dinner
- Saturday and Sunday Lunch
- Sunday Dinner, a meal at a restaurant provided by Stephen Wise Temple
- some snacks 

Meals not included:
- Saturday Dinner, free time in Georgetown (many restaurant options, typically $30 per person)
- Monday lunch, participants purchase lunch from one of several congressional office cafeterias
- any additional snack or meal at airports or during free time 
 

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Requirements for Registration

• Participant information
  • Full legal name
  • Date of Birth
• Deposit
• Agreements for participation

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Parent 1 Information

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Participant Information

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Trip Participant Medical Information

In the event of an emergency, please contact the following person(s) in the order presented:

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I AGREE that the undersigned of this WAIVER AND RELEASE OF LIABILITY is the Parent or Guardian of the PARTICIPANT herein this WAIVER AND RELEASE OF LIABILITY, and that the PARTICIPANT hereinafter will also be considered as “my child”.

IN CONSIDERATION OF the risk of injury that exists while participating in L'TAKEN SEMINAR (hereinafter the “Activity”); and

IN CONSIDERATION OF my desire for my child to participate in said Activity and being given the right to participate in same;

I HEREBY release and forever discharge STEPHEN WISE TEMPLE located at 15500 Stephen S. Wise Drive, Los Angeles CA 90077, as well as KOL TIKVAH, located 20400 Ventura Boulevard, Woodland Hills CA 91364, their affiliates, managers, members, agents,  attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns (collectively “Releasees”), from any physical or psychological injury that my child may suffer as a direct result of their participation in the aforementioned Activity.

MY CHILD IS VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND IS PARTICIPATING IN THE ACTIVITY ENTIRELY AT THEIR OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY CHILD’S OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). NONTHELESS, I AND MY CHILD ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME AND MY CHILD, OF THEIR PARTICIPATION IN THIS ACTIVITY.

MY CHILD AND I FURTHER AGREE to indemnify, defend, and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me and/or my child of anyone on their behalf, including attorney’s fees and any related costs.

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that my child should require medical care or treatment, I authorize Temple Judea to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, and the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that my child should carry their own health insurance.

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE TEMPLE JUDEA AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST TEMPLE JUDEA FOR PERSONAL INJURY OR PROPERTY DAMAGE ON BEHALF OF MY CHILD.

To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence of the part of Temple Judea, its agents, and employees.

I agree that this Release shall be governed for all purposes by California law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written or other agreements.

THIS AGREEMENT was entered into at arm’s-length, without duress of coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Parent or Guardian of Participant, aforementioned herein, and Temple Judea agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain that terms of this agreement, but it will be interpreted based on the language in accordance with the purposes for which it is entered into.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision shall be deemed to be written, construed and enforced as so limited.

I, THE UNDERSIGNED PARENT OR GUARDIAN OF THE PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT THAT I AM SIGNING IT OF MY OWN FREE WILL ON BEHALF OF MY CHILD.


Medical Release
In the event that the undersigned, or my/our authorized physician, cannot be reached and in the judgment of the authorized staff member, there is a necessity for immediate examination and/or treatment of my child, I hereby request and authorize any of the authorized staff members to obtain for my child such medical services as are deemed necessary. I agree to assume the financial responsibility for any diagnosis/treatment and/or for medications deemed necessary.

Photography Release
I grant power to Wise Temple to take photographs, movies, videos of my child while my child is participating in Wise Temple activities and for Wise Temple the right to edit, use, and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release Wise Temple from all claims, demands, and liabilities whatsoever in connection with the above.


By providing my electronic signature, I agree to all terms detailed above.

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