USY - 2025/2026 Program Registration

USY/ Gesher Programs
Join us as we connect with Simkin residents during Rabbi Kliel’s service, then paint flower pots to brighten their day!

10:00–12:00 PM • $5 per person

WE meet at Simkin Centre: 1 Falcon Ridge Dr.
Parent/Guardian Information

The participant(s) information will be required on the next page
Your Name*

First NameLast Name
Your Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a Congregation Etz Chayim Member?*

YesNoNo, but would like to know more
How did you hear about us?
You selected other, please expand
How many people will be attending? (kids)*

Confirmation of Registration
All food will be kosher, please let us know if you require any other dietary accommodations.
*
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Sunday, January 25- at Simkin CentrePlease select the number of people attending
$5.00CAD Quantity

Optional Donationswe would be grateful for any donations to help support future USY programming. Your generosity helps us continue to create meaningful, fun, and engaging experiences for our youth.
$5.00CAD Quantity

Total

$0.00CAD

How many Adults would you like to register
Please include the Name, Email, & phone number of the Adults
Example: Name Last Name, usy@etzchayim.ca, 204-xxx-xxxx

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

USY/ Gesher Programs