Thank you SO MUCH for your willingness to be a host family for the Gesher Kinnus (middle school) USY Convention, February 10-12! It is because of generosity and hospitality like yours that we are able to put on exciting and meaningful conventions for the Jewish youth of Kansas City and the region!

____________________________________________________________________________

I certify that:


(1) All driving of the teens throughout the weekend will be done by someone of the age of 21 or older with a valid drivers license, valid car insurance, and no moving violations within the past 5 years (excludes minor traffic offenses).


(2) There will be seat belts for all those being transported to and from my home.


(3) An adult over the age of 21 will be present in the home at all times that the participants are present in the home.


(4) Any alcohol or medications will be locked away at all times that the participants are in the home.


(5) Any firearms that my family owns will be locked away and unloaded during the event.


(6) After scheduled pickup, participants will be taken immediately home and remain there until they go back to the specified location at the time indicated by the Gesher Kinnus schedule.


(7) I will ensure that all participants abide by the International USY bullying, hazing, drugs, and alcohol policy in our home. The policy states: "We have a zero tolerance policy for drugs or alcohol at our events. If you are found with these items in your possession, you will be sent home and not allowed to attend regional events for one full year from the date of the incident. In our efforts to create a positive and inclusive environment, USY has a zero tolerance policy for bullying and hazing. Any such behavior is unacceptable and unwelcome at our events".


* By checking the "I agree" box, I certify that myself and all residents of my home agree to embody and enforce the above guidelines set forth by KCUSY and Congregation Beth Shalom
* Name (First and Last)
0/250
* Mobile Phone Number (this is the number you will be contacted at throughout the weekend)
0/250
* Email Address
0/250
* Please list the names and ages of every resident of the household that will be present in the home the weekend of the convention
0/500
* Do you have a pet?
If you answered yes, what kind of pet do you have?
0/250
* Is your home nut free?
* Is your home 1.5 miles or less from the synagogue?
If you live within 1.5 miles of the synagogue, is the walk to/from the host synagogue to/from your home safe and well-lit?
* Do you have a child attending Gesher Kinnus?
* Do you have a non-participating child between the ages of 10-21 living in your home during this event?
* How many teens are you willing to host for the event (including participants who live in your home)?
0/250
* Who would you prefer to host?
0/250
* Do you have any firearms in your home?
Please provide any additional information about your home that you feel we should know
0/500