Sar-El Canada Application

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*To submit this form you will need at a scanned copy of your Passport picture page and a signed Sar-El Israel waver.

Personal Information

Name (As shown on your passport)*

First Middle Last

Date of Birth*

Sex*

Male

Female

Please Indicate your legal Sex as shown on your passport.

Occupation*

Religious affiliation*

Jewish

Other

Medical:

CPAP

Allergies

Please indicate if you have a CPAP or allergies that could affect you.

Allergies:*

Please describe any relevant allergies.

Address*

Street Address City Province Postal Code

Phone*

Home Phone

Mobile Phone

Work Phone

Home Phone*

Mobile Phone*

Work Phone*

Email*

Enter Email Confirm Email

Email Consent*

I consent to receiving email from Sar-El Canada and Sar-El Israel.

Your consent to receive email from Sar-El Canada is necessary for inclusion in the program. You accept that Sar-El Canada will give your email address to Sar-El Israel to enable your registration in the program.

Sar-El Canada may also email you an invitation to participate in a post-program survey, occasional local Sar-El Canada event notifications or newsletters.

Mailing List*

Please indicate which mailing list is most appropriate.

Requested Program

Program Start Date*

Returnee applications must be received at least 6 weeks prior to the program start date. First time volunteer applications must be received at least 7 weeks prior to the program start date. Final documentation must be received no later than 5 weeks prior to the start date. Applications not received within these minimum lead times may not be accepted.

Program Length

3 Weeks

2 Weeks

1 Week

Other

Sar-El T-Shirt Size

When available, Sar-El Israel provides volunteers with a Sar-El T-Shirt. If you would like one, please indicate the size.

First time?*

Yes

No

Is this your first time volunteering with Sar-El? If so, you will need an interview and a letter of reference from your rabbi or other recognized community leader.

How many trips you've taken?*

Please enter a number less than or equal to 99.

How did you hear about Sar-El*

Passport Information

Please enter your passport information here. Be sure to fill in your emergency contact information in your passport.

Passport*

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, docx, Max. file size: 200 MB, Max. files: 2.

Click on the upload box to browse your computer, drag a file from your file explorer or use your cell phone or tablet camera to scan. Allowed Types are jpg, jpeg, gif, png, pdf, docx.

Canadian Passport #*

Expiry Date*

Please add the following additional, Non-Canadian, passport information only if applicable. Canadian passport holders must provide their Canadian passport information above.

Other Passport #

If Applicable

Other Expiry Date

If Applicable

Other Passport Country

If Applicable

Volunteering with:

Indicate who you want to be together with on base. Leave blank if you are going alone.

In case of emergency

Contact in Canada

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Emergency Contact Email*

Phone*

Relationship*

In case of emergency

Contact in Israel

Name

First Last

Address

Street Address Address Line 2 City Zip Code

Israel Contact Email

Phone

Relationship

Agreement 1

TERMS FOR PARTICIPATION IN THE SAR-EL PROGRAM

Sar-El Canada is the Canadian representative of Sar-El. Sar-El is the Israeli sponsor and supplier of the Sar-El Work and Study Program (the "Program") in which volunteers work on an Israel Defence Forces base or at other locations in Israel. In Montreal, Sar-El Canada uses space provided by the Bronfman Israel Experience Centre (BIEC) but has no other affiliation with BIEC, with the Bronfman Jewish Education Centre (BJEC) or with FEDERATION CJA (FCJA).

I have received and read all materials provided to me by Sar-El Canada, including the rules, procedures, guidelines, terms and conditions of the Program. I hereby agree to follow all such rules, procedures, guidelines, terms and conditions, including those set out below, or such further rules that may be established by Sar-El Canada or Sar-El during my participation in the Program

Terms and Conditions

(A) Sar-El Canada offers the Program as the Canadian representative of Sar-El. In that capacity, Sar-El Canada acts only as an intermediary between the participant and the companies, directors, organizations, and suppliers of goods and services (all of the foregoing individually and collectively called the “Suppliers”) for the Program. The liability of the Suppliers may be limited by law, tariffs, ticket, vouchers, or other documents.

(B) Sar-El Canada and Sar-El reserve the right to cancel, alter, or modify any part of the Program in their sole and absolute discretion with or without prior notice.

(C) Participants may be immediately dismissed from the Program in Israel for proselytizing, use of alcohol or drugs, leaving the IDF base (or other Program location) or off-base Program activity without prior notification and authorization, or other behavior incompatible with the standards reasonably expected of participants, including behavior deemed to be dangerous to persons, property, or security.

(D) Dismissal from the Program will result in immediate removal from the IDF base (or other Program location), and the participant will be solely responsible for expenses incurred thereafter, including but not limited to lodging, transportation and meals. In addition, Program fees paid will not be refunded.

(E) Some travel at or near the international boundaries of the State of Israel may be in non-scheduled and noncommercial aircraft or other means of land or air transport and may include travel and meetings within internationally disputed areas and the Participant’s life, medical, travel or other insurance may not provide coverage for loss, damage, injury, or death in these circumstances.

(F) I affirm that I have no intention of serving in, joining, or swearing allegiance to the Israeli Defence Forces, and that I am participating as a civilian volunteer.

(G) In the event a Participant is dismissed from the Program or voluntarily leaves the Program, any obligations that Sar-El Canada and Sar-El may have under this Agreement or arising from that person’s participation in the Program shall immediately cease. The Waiver, Release and Indemnification provided herein shall survive the termination of this Agreement

Agreement 2

WAIVER, RELEASE AND INDEMNIFICATION

I HEREBY AGREE to participate in the Program upon the express understanding and condition that:

1. I am at least 18 years of age.

2. I have been advised that the Program may call at times for vigorous exertion and physical effort under spartan living conditions. I declare that I am in good physical condition and in good mental health, physically capable of participating in this Program, and have consulted and obtained confirmation of such from my personal physician or other health authority before agreeing to participate in this Program. I have submitted my signed Medical Certificate which fully and accurately sets out any relevant medical conditions to the best of my knowledge.

3. I hereby authorize Sar-El Canada, Sar-El and any person who is in custody of my medical records to release those records to the appropriate medical personnel in Israel. Sar-El Canada and Sar-El undertake to seek and release such records only where this reasonably appears to be in my medical interest.

4. I understand that I may be responsible for the cost of any medical attention or treatment or related services that I may require while on the Program. I will carry, at my expense, adequate health insurance. It has been recommended, but not required, that I carry travel insurance. I am fully aware that provincial health insurance and some private insurance plans do not provide full coverage outside of Canada.

5. I understand that I will be required to leave the base on weekends and some holidays, and that I am responsible for my own off-base arrangements including, in particular, transportation and accommodation off-base for Thursday, Friday and Saturday nights. In the event that I agree to accept any such arrangements made on my behalf by Sar-El personnel or participants, I accept full personal responsibility for them and agree to hold Sar-El Canada, Sar-El, BIEC, BJEC and FCJA harmless for any injury, prejudice or damage I may sustain related to or arising from them.

6. I recognize that there are inherent risks in participating in the Program and I hereby expressly assume the risk for all losses, illness and injury that may result from my participation. In consideration for acceptance of my application in the Program and the substantial organizational and other benefits provided to me by Sar-El Canada and Sar-El, I hereby expressly waive for myself, my heirs and assigns any and all claims, costs, liabilities, defences or judgments including legal fees and court costs (herein after collectively referred to as Claims) against Sar-El Canada or Sar-El, BIEC, BJEC and FCJA arising out of my participation in the Program including any losses, illness or injury suffered by me while travelling to, from or participating in the Program.

7. I hereby further agree to indemnify and hold harmless Sar-El Canada and Sar-El and BIEC, BJEC and FCJA their employees, trustees and officers and any other persons or entities involved with SarEl Canada or Sar-El or BIEC, BJEC and FCJA from or against any and all such Claims. I further agree to indemnify and hold Sar-El Canada or Sar-El or BIEC, BJEC and FCJA harmless from any and all Claims that may be brought against Sar-El Canada or Sar-El or BIEC, BJEC and FCJA on account of misconduct on my part.

8. The invalidity of any particular provision of this agreement shall not affect any other provision of it, but the agreement shall be construed as if the invalid provision had been omitted.

9. The present agreement is governed by the laws applicable in the province of Ontario.

10. I acknowledge that I have been advised to obtain independent legal advice and have done so, or by my electronic Agreement, have waived doing so.

11. I understand and accept that personal information provided to Sar-El Canada including my email address, will be provided to Sar-El Israel and the Israel Defense Force to gain my acceptance into the Program

12. The present Agreement is drafted in the English language at my request. La présente entente est redigée en langue anglaise à ma demande.

Sar-El Israel Waiver and Release

Note you will need to sign and submit a separate waver from Sar-El (Israel)

Program History, Documentation and Approval

I will be attaching my:

Medical Certificate

Medical Insurance

Reference Letter (First time volunteers only)

Please identify which documents you will be attaching. Note: any missing documents may be submitted at a later date but will be required for your final acceptance.

Upload: Medical, Insurance, and/or Reference letter here.

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, docx, Max. file size: 200 MB, Max. files: 5.

Please attach your documents here by dragging them or selecting them. Be sure to indicate which documents you will be attaching.

Flight Information

If available, please provide the following information about your flights.

Airline name

Flight number

Arrival Date

Arrival Time

Final Agreement

I am submitting or will submit the following:

The AGREEMENT ON THE TERMS FOR PARTICIPATION IN THE SAR-EL PROGRAM that I have read and agreed to.
My MEDICAL CERTIFICATE confirming that I am in good health and have disclosed any illness or other condition that could impede my performance on the program,
A clear copy of the picture page of my valid passport
Proof of valid Medical/Hospital insurance coverage for Israel,
The registration fee. If payment by cheque, payable to Sar-El Canada or if via Interac email transfer, to toronto@sarelcanada.org.
The separate Sar-El (Israel) registration fee, payable to Sar-El (Israel) after acceptance by Sar-El Canada.

In participating as a Civilian volunteer in this Sar-El group, I have no intention of serving in, joining, or swearing allegiance to the Israel Defense Forces (IDF).

APPLICATIONS ARE SUBJECT TO IDF SECURITY CHECK AND ACCEPTANCE.
SAR-EL CANADA RESERVES THE RIGHT, AT IT'S SOLE DISCRETION, TO ACCEPT OR NOT TO ACCEPT ANY APPLICANT.

General Comments / Notes

Phone

This field is for validation purposes and should be left unchanged.

Application Form

Personal Information

Requested Program

Passport Information

In case of emergency

In case of emergency

Agreement 1

Terms and Conditions

Agreement 2

Sar-El Israel Waiver and Release

Program History, Documentation and Approval

Flight Information

Final Agreement