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ZL Shabbaton registration 5785
Name of Shabbaton attendee
(Required)
First
Last
Who is filling out this form?
(Required)
Shabbaton attendee
Parent/legal guardian
Sibling
Email (all Shabbaton-related communications will be sent to this email address)
(Required)
Best number to reach parent/guardian
(Required)
Best number to reach attendee
(Required)
Would you like to receive text reminders?
(Required)
Yes
No
Cellphone number for text reminders
(Required)
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Have you previously attended a Zisel's Links Shabbaton?
(Required)
Yes
No
Are you receiving our magazines?
(Required)
Yes
No
DOB
(Required)
MM slash DD slash YYYY
Age
(Required)
13
14
15
16
17
18
19
20
21
22
23
Grade
(Required)
9
10
11
12
Post-high school
Name of school currently attending
(Required)
Please attach a picture of yourself. (Just yourself. Not a group, 'cuz then we don't know which one is you 😉
(Required)
Max. file size: 100 MB.
This picture is for internal use only and won't be used for any other purpose.
Which nusach do you daven?
(Required)
Ashkenaz
Ari/Chabad
Eidut Miizrach
Sefard
Stolin
Dietary/kashrus needs (all food is under Tarnipol hashgacha and is Cholov Yisroel, Pas Yisroel, and chassidishe shechita)
(Required)
Allergies
Beit Yosef
Dairy free
Gluten free
Lubavitch shechita
Yoshon
No specific needs
What are you allergic to?
(Required)
Will you be bringing an EpiPen?
(Required)
Yes
No, I don't need one
Which parent(s) passed away?
(Required)
Mother
Father
Both
Hebrew date of your mother's yahrtzeit
(Required)
How long ago was your mother niftar?
(Required)
0-6 months
7-11 months
1-3 years
4-6 years
7-10 years
11-15 years
16+ years
Mother's full Hebrew name (mother's name bas father's/mother's name) for inclusion in the yahrtzeit calendar. (This is completely optional. But if you'd like your mother's name & yahrtzeit included in the calendar, you gotta put it here.)
Please attach a picture of your mother to be displayed on our Wall of Honor at the Shabbaton. (This is completely optional. The Wall of Honor is just photos and doesn't include names. If you're a parent/legal guardian/sibling filling out this form on behalf of the attendee, please discuss this with the attendee before attaching a photo.)
Max. file size: 100 MB.
Has your father remarried?
(Required)
Yes
No
Hebrew date of your father's yahrtzeit
(Required)
How long ago was your father niftar?
(Required)
0-6 months
7-11 months
1-3 years
4-6 years
7-10 years
11-15 years
16+ years
Father's full Hebrew name (father's name ben father's/mother's name) for inclusion in the yahrtzeit calendar. (This is completely optional. But if you'd like your father's name & yahrtzeit included in the calendar, you gotta put it in here.)
Please attach a picture of your father to be displayed on our Wall of Honor at the Shabbaton. (This is completely optional. The Wall of Honor is just photos and doesn't include names. If you're a parent/legal guardian/sibling filling out this form on behalf of the attendee, please discuss this with the attendee before attaching a photo.)
Max. file size: 100 MB.
Has your mother remarried?
(Required)
Yes
No
Do you have younger siblings who won't be attending Shabbaton?
(Required)
Yes
No
What are their names and ages?
(Required)
Do you have any medical or mental health conditions we should be aware of?
(Required)
Yes
No
Please specify
(Required)
Where will you be leaving from on Friday morning?
(Required)
Baltimore
Boro Park
Crown Heights
Five Towns
Flatbush
Lakewood
Monsey
New York City
Passaic
Philadelphia
Queens
Staten Island
Teaneck
Williamsburg
Please note that we do not allow girls to drive to Shabbaton on their own. All attendees must come with the provided transportation.
Where will you be returning to on Sunday afternoon?
(Required)
Airport - EWR
Airport - JFK
Airport - LGA
Baltimore
Boro Park
Crown Heights
Five Towns
Flatbush
Lakewood
Monsey
New York City
Passaic
Philadelphia
Queens
Staten Island
Teaneck
Williamsburg
Please note that all attendees must leave with the provided transportation.
Will you be flying in?
(Required)
Yes
No
Did you submit a "Request for Reimbursement" form? (Please note: we will not be booking any flights this year through our office. All attendees should book their own flights. See below for reimbursement details.)
(Required)
Yes, I submitted the form already
I didn't submit it yet. I understand that it must be submitted before 2 p.m. EST on Friday, Dec. 27
No, I don't want to be reimbursed
Please note that reimbursement will only be made if the "Request for Reimbursement" form was submitted before 2 p.m. EST on Friday, Dec. 27. Email linksshabbaton@gmail.com if you need the link to the form.
Please submit 2-3 names of girls you'd like to room with. (If you need time to think about your rooming requests, you can email linksshabbaton@gmail.com up until Dec. 25. After Dec. 25, we cannot consider any additional rooming requests.)
What camp(s) have you attended? (This information can sometimes help us with rooming ideas.)
Most rooms are double or triple occupancy, however, there are some rooms with only one bed. Are you OK with sleeping in a room on your own?
(Required)
Yes, I prefer my own room
I'm OK with it, but it's not my first choice
No, I don't want to be on my own
Please choose up to 3 of the following options for Self-Care Sunday. (All girls will get a Shopathon appointment.)
(Required)
Hairstyling
Haircut
Makeup consult or application
Head & neck massage
Which of the following would you like to meet? (Check as many that apply)
(Required)
Shadchan
Career coach
Job recruiter (tristate area)
None of the above
What type of boy are you open to meeting? (Please check all that apply)
(Required)
Working
In college
Learning part-time
Learning full-time
Chabad
Chassidish
Heimish
Litvish
Modern Orthodox
Sephardic
Syrian
Yeshivish
Would you like to contribute your artwork, poetry, or an original song you recorded to be included in our Grief Gallery that will be displayed at the Shabbaton?
Yes
No
Not sure - I'd like more info about this
Got questions you want addressed anonymously at the Q&A panel? Drop 'em here or email them to linksshabbaton@gmail.com
Shabbaton is a time to connect. To that end, we ask that phones be deposited in the phone drop box upon arrival, to be used only within the designated phone area throughout the weekend. We ask that no phones be used on the transportation to and from the Shabbaton.
(Required)
I agree
We love seeing everyone! However, it takes a lot of time and effort to pull this Shabbaton together. Therefore, if you cancel at any point after midnight on December 23 for any reason other than being sick, we will charge the card listed below $100 to help defray the cost.
(Required)
I agree
Credit card number
(Required)
Expiration date
(Required)
Security code
(Required)
ZIP code
(Required)
Refer a Family
Family Name
(Required)
Family City
(Required)
Parent Lost
(Required)
Name of Surviving Parent
Name of Referrer
First
Last
Phone Number of Referrer
Email of Referrer
(Required)
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