Registration

Monday Evenings, 7:00-8:30 PM
Teen's Name:*
First Name Last Name
Date of Birth:*

Month Day Year
Teen's Phone Number

Area Code Phone Number (Teen's)
Teen's E-mail:*
Teen's School:*
Teen's Grade:*
Parent's Names:
First Name Last Name
Parent's Phone Number:

Area Code Phone Number (Parent's)
Parent's E-mail:
Emergency Contact
Primary Emergency Contact Name:*
First Name Last Name
Phone Number:*

Area Code Phone Number
Relationship to Child:*
Secondary Emergency Contact Name:
First Name Last Name
Phone Number:

Area Code Phone Number
Relationship to Child:
Medical Information
Hospital/Clinic Preference:*
Physician’s Name:*
First Name Last Name
Physician’s Phone Number:*

Area Code Phone Number
Insurance Company:
Policy Number:
Allergies/Special Health Considerations:
Authorization:*

I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency.I give permission for my child to go on field trips. I release Aventura Chabad and individuals from liability in case of accident during activities related to Aventura Chabad, as long as normal safety procedures have been taken.By entering your first and last name below, you electronically acknowledge having read and understood this Agreement and agree to the terms and conditions herein.Your first and last name below represents your agreement to all the terms and conditions written above and will serve as your consent to all the terms and conditions written above.
Signature:*
First Name Last Name
Date:*
Additional Notes / Information
New York Shabbaton
Dates: Feb 19-22, 2026
There is an optional trip to NYC for an additional fee where around 4,000 teens from all around the world meet and participate in a weekend Shabbaton (Thursday - Sunday). For more information visit: https://shabbaton.cteen.com/
You can add the trip now for an additional $950 which will be added to your total and reflected in your payment plan. The cost includes airfare, housing, meals, and activities. (The trip is only offered to registered C-Teen participants)

Note: You can decide to add the trip later, but the price will go up with time.

Trip Deadlines and Costs:
Early Bird until Nov 16: $950

Regular Price until Dec 19: $1,100
Late Registration until Jan 11: $1,250
Financial Aid Application: due by November 10, 2025
*Financial Aid will be granted based on need and availability. If you are certain that you want your teen to attend the Shabbaton, but have financial needs, please contact [email protected] for information on scholarship applications.


Cteen Prices: (Excluding trips) (9th-12th Grade) NY Trip: $950 Leaders: $200 Discount	Cteen Junior Prices: (7th-8th Grade)
$550 - Non-Members $500 - Members	$550 - Non- Members $500 - Members
Pre-Registration by May 15: $50 Discount

Have you been chosen by the Director as a Leader?*

YesNo
Current member?*

YesNo
Teen Division:*

Cteen (9th - 12th Grade)Cteen Jr (7th - 8th Grade)
Teen Division:*

Cteen (9th - 12th Grade)Cteen Jr (7th - 8th Grade)
Are you a current member?

YesNo
Include NYC Shabbaton:*

YesNo
Total Amount:

$0.00
Please note that a 3.5% charge will be added to Credit Card payments. If you wish to pay with a different method, please continue with the registration as payment is charged manually, and contact the office at 305-933-0770 to discuss other payment options.

Payment:*

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Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

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Payment Options:

Full Payment2 Payments3 Payments6 Payments
Terms of Agreement
(PLEASE READ CAREFULLY-NO EXCEPTIONS)
I understand:*

1. Payment in full is due with application, including all head checks or credit cards.2. Payment is Non-Refundable, for any reason, even if your child does not attend the program.3. Withdrawal of enrollment privileges, for any reason, does not relieve the Undersigned of the responsibility for the payment of the entire financial obligations for the program you enrolled your child in.4. By entering your first and last name below, you electronically acknowledge having read and understood this Agreement and agree to the terms and conditions herein.5. Your first and last name below represents your agreement to all the terms and conditions written above and will serve as your consent to all of the terms and conditions written above.
Signature:*
First Name Last Name
Date:*
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Monday Evenings, 7:00-8:30 PM

Emergency Contact

Medical Information

New York Shabbaton

Terms of Agreement