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Casino Trip August 2022
Please verify reCaptcha before submitting the form.
Number of people attending the casino trip
Select One
1
2
3
4
*
Guest #1 First Name
*
Last Name
*
Email Address
*
Phone Number
*
Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
*
Date of Birth (the casino requires this information)
L'Auberge My Choice # (only if you have one)
*
Emergency Contact Name (must not be attending the casino trip)
*
Emergency Contact Phone Number
*
Guest #2 First Name
*
Last Name
*
Email Address
*
Phone Number
*
Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
*
Date of Birth
My Choice Number
*
Emergency Contact Name (must not be attending the casino trip)
*
Emergency Contact Phone Number
*
Guest #3 First Name
*
Last Name
*
Email Address
*
Phone Number
*
Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
*
Date of Birth
My Choice Number
*
Emergency Contact Name (must not be attending the casino trip)
*
Emergency Contact Phone Number
*
Guest #4 First Name
*
Last Name
*
Email Address
*
Phone Number
*
Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
*
Date of Birth
My Choice Number
*
Emergency Contact Name (must not be attending the casino trip)
*
Emergency Contact Phone Number
Release and Waiver of Liability
Description of Activity:
Day Trip to L'Auberge Casino
1.
Waiver and Release.
I, the Participant, release and forever discharge and hold harmless HCRJ and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my participation in the Activity. I understand and acknowledge that this Release discharges HCRJ from any liability or claim that I, the Participant, may have against HCRJ with respect to any bodily injury, personal injury, illness, death, or property damage that may result from my participation in the Activity. I also understand that HCRJ does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance, in the event of injury, illness, death, or property damage (see insurance requirements below.)
2.
Insurance.
I, the Participant, understand that HCRJ does not carry or maintain, and expressly disclaims responsibility for providing any health, medical, or disability insurance coverage for the Participant. EACH PARTICIPANT IS EXPECTED AND ENCOURAGED TO ARRIVE WITH MEDICAL OR HEALTH INSURANCE AND COVERAGE IN EFFECT.
3.
Medical Treatment.
I hereby release and forever discharge HCRJ from any claim whatsoever that arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my participation in the Activity.
4.
Photographic Release.
I grant and convey unto HCRJ all rights to use and publish any photographic images of me made by HCRJ during my participation in the Activity.
5.
Other.
I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Texas, and that this Release shall be governed by and interpreted in accordance with the laws of that State. I agree that in the event that any clause or provision of the Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of the Release, which shall continue to be enforceable.
Executed as of the date set forth above.
*
Click here if all registered participants agree to the terms in the Release and Waiver of Liability form above.
Click here if all registered participants agree to the terms in the Release and Waiver of Liability form above.
Wed, November 29 2023
16 Kislev 5784
Friday Night
Candle Lighting
: 5:04pm
Shabbat Day
Havdalah
: 6:12pm
This week's Torah portion is
Parshat Vayishlach
Shabbat, Dec 2
Candle Lighting
Friday, Dec 1, 5:04pm
Havdalah
Motzei Shabbat, Dec 2, 6:12pm
Erev Chanukah
Thursday, Dec 7
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Wed, November 29 2023 16 Kislev 5784