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Student & Parent Consent Form

This section is to be read and filled in by the Applicant and Parent/Guardian. Please read each and every statement below and confirm that you agree with all statements, by clicking on the relevant ‘tick box’ and/or filling in an answer where applicable.

PARENT PERMISSION (This section needs to be read and filled in by the Applicant’s Parent or Guardian)

This trip is psychologically challenging. It may trigger many different emotions in your child. Therefore we ask you to carefully consider whether this program is right for your child. Your utmost honesty and sincerity will not only benefit your child but it will also ensure that he/she plus all the other participants and Staff maximise the opportunity that the Program offers. Please comment on the following (this information is held in the strictest confidence:)



  • I agree to hold the leadership of March of the Living Australia (MOTL), its representatives and staff, free from any liability arising out of transporting, supervising, or any other activity pertaining to this program for the above named applicant. I agree to indemnify March of the Living Australia for any costs incurred for the above named applicant that may arise in connection with this trip over and above the cost of the trip.
  • I also give my full permission for all treatment of any nature deemed necessary by doctors and/or psychologist/counsellor on the program be extended to my child within the framework of medical services provided by MOTL. I am aware that whilst there is usually a psychologist / counsellor accompanying the program, time and circumstances may preclude problems of a psychological nature being resolved whilst on the program. I undertake to review my child’s needs in this regard should the circumstances warrant.
  • I have read the separate “Code of Conduct” with my child and my child understands it fully. I further understand that if, as a result of my child’s non-compliance with the rules, he/she must leave the program immediately and any extra costs as a result of this will be repaid by me.
  • I have read my child’s statement above and agree to all its conditions.

I,:

MOTL's STATUS VIS-A-VIS SCHOOLS (This section needs to be read and filled in by the Applicant and Applicant's Parent or Guardian)

  • We acknowledge that each of us understands and recognises that March of the Living Australia (MOTL) is an autonomous and independent organisation that is in no way a subsidiary of any Jewish Day School in Australia. MOTL runs its own programs independent of any Jewish Day School authority or control.
  • We understand that any agreement entered into between MOTL and ourselves is done so outside of the jurisdiction of our child's school. Participation on MOTL is a private arrangement between ourselves and MOTL.
  • We understand that the role of the Schools/Colleges is limited to allowing the students leave of absence from school during the program period and to provide moral (and where possible educational) support to the student should they be accepted to participate on the MOTL program.
  • We also understand that MOTL personnel act in an independent capacity unrelated to any association they may have with a specific Jewish Day School. MOTL appoints its own staff and they are not representatives of the Schools that they may be employed by. They are subject to the authority and jurisdiction of MOTL International whilst participating on the program.
  • There is no requirement set by any Jewish Day School that students participate on the MOTL program and non-participation will have no adverse impact insofar as any scholastic requirements of the student are concerned.
  • No Jewish Day School or Non Jewish Day School takes any responsibility for the safety of the student whilst on the MOTL program.
  • We make an informed decision that we understand and acknowledge that we participate in the program as MOTL participants, not as representatives of our own or any other Jewish Day School or Non Jewish Day School in any way.

I,:

I,:

PHOTOGRAPH, VIDEO & PUBLICATION RELEASE AUTHORITY (This section needs to be read and filled in by the Applicant and Applicant's Parent or Guardian)

  • MOTL Australia may take a legal, age-appropriate recording of your likeness, voice and performance in the program. MOTL Australia may edit the recording at its discretion and use the legal and age-appropriate recording (in whole or in part) in all media throughout the world without further consent or cost. This will include the right to synchronise the audio from the recording with other visual images and the vision with other audio.
  • MOTL Australia will own the copyright in the recording. You grant MOTL Australia non-exclusive licence in any material in which you are listed as the participant, author or composer to exploit the recording as set out in this release. You warrant that the consent of no other person is required to enable MOTL Australia to record your performance of such material and to exploit the material.
  • MOTL Australia may use your name, photograph, voice and biographical material in any publicity or promotion of the Program. I hereby give permission for MOTL Australia to use my writings, photos, journal entries, poetry or drawings that may arise in the future.
  • You warrant that you have the right to accept this engagement and indemnify MOTL Australia against any action, claim, legal costs, expenses, damages for which MOTL Australia may be liable and which arises from any statements or actions made by you during the MOTL Australia participation.

I,:

I,:

CODE OF CONDUCT AND RELIGIOUS POLICY: RULES AND REGULATIONS (This section needs to be read and filled in by the Applicant and Applicant's Parent or Guardian)

March of the Living Australia (hereafter referred to as MOTL) has established the following standards and rules to further the interests of a successful program. ALL PARTICIPANTS MUST, TOGETHER WITH THEIR PARENTS/GUARDIAN, SIGN THE DECLARATION AT THE END OF THIS DOCUMENT THUS AGREEING TO ABIDE BY ALL STANDARDS AND RULES.

Applicants unwilling to do so should withdraw their application. INFRACTION OF ANY OF THESE STANDARDS OR RULES WILL BE CONSIDERED JUSTIFIABLE GROUNDS FOR EXPULSION FROM THE PROGRAM.

Please understand that adherence to these standards and rules will be beneficial to your participation in the program. Past experience shows that these standards and rules assist in the smooth running of the MOTL program.

CODE OF CONDUCT

Mobile Phones

Inappropriate photographing including the photographing of people without their agreement and the inappropriate use of photographs; sexting; use of mobile phones during designated program times etc is not permitted. Infraction of this rule will result in appropriate disciplinary action including possible confiscation of your phone for the entire duration of the trip.

Punctuality

Participants are expected to arrive on time to all program activities, including bus departures, meals, prayers and group discussions. Lateness causes many unwanted disruptions to the daily itinerary and especially security. Infraction of this rule will result in appropriate disciplinary action.

Curfew

Participants are expected to strictly observe evening curfew times in both Poland and Israel. These times will be determined by the MOTL staff and infraction of this rule will result in appropriate disciplinary action.

Participation

During the entire program, participants are obliged to remain in the group and participate in all group activities unless written permission to the contrary is obtained from the group leaders. ALL ACTIVITIES ARE COMPULSORY.

Anti-Social or Unacceptable Behaviour

All participants should regard themselves as representatives of their school, community and Australia. They must obey the rules of any institution they visit and conduct themselves at all times in a manner that will reflect positively upon themselves and their group. Repeated behavioural problems or anti-social behaviour will result in expulsion from the program, however individual infraction of these rules will also result in disciplinary action. Anti-social and unacceptable behaviour includes but is not limited to:

  • Verbal, physical or sexual bullying or intimidation of others
  • Disrespecting others for their opinions, personal taste or style
  • Sexual harassment however overt or subtle
  • Rudeness or lack of concern or respect for others
  • Racist, sexist or homophobic behaviour, however overt or subtle, whether directed towards other group members, or made generally
  • Endangering the health, safety, security of themselves or others through their actions, or through their failure to act in a responsible and appropriate way
  • Involvement in acts of violence or vandalism, whether it be against other people or property
  • Disruption of sessions
  • Exhibiting rudeness or disrespect to group leaders, fellow participants, hotel staff, drivers, guides and security staff
  • Failure to participate in all group activities
  • Stealing or the taking of items that do not belong to the individual involved

The above list that outlines anti-social and unacceptable behaviour is not intended to be exclusive or exhaustive. MOTL reserves the right to deal as it sees fit with any behaviour it deems to be anti-social, detrimental to the group or detrimental in any way to the program. Any participant who is expelled from the program for anti-social or unacceptable behaviour will not be eligible for any refund from MOTL and must return to Australia immediately, at their own expense.

Cigarettes

Smoking is not permitted on the MOTL program. Students found even in the possession only of cigarettes will be given one warning. A further infraction will result in expulsion from the program.

Alcohol

Students are not permitted to consume alcohol of any sort or buy any alcohol - duty free at the airport or otherwise (upon leaving Australia or on their return). MOTL reserves the right to expel any participant from the program for possession or use of alcohol.

Nargillah

Students are not permitted to buy Nargillah and/or Nargillah products whilst in Israel. MOTL reserves the right to confiscate this purchase and take disciplinary action as necessary.

Piercings

No body piercing is allowed while on the MOTL Program. Students are not permitted to have new piercings done, especially while in Israel.

Drugs

Drugs are illegal in Poland, Israel and Australia. Participants found to be using, selling, or to have any involvement with illegal drugs will, at the sole discretion of MOTL and any participating organisations, be immediately expelled from the program and must return to Australia at their own expense. In addition, MOTL has a duty to report illegal drug use or possession to Polish and Israeli authorities. Participants' parents/guardians and school principals will also be informed of the reasons why they have been sent home.

Expulsion

Any participant who is expelled from the program for infraction of the Code of Conduct and /or the Rules and Policies stipulated above, will automatically release MOTL of any responsibility or liability of any kind resulting from this expulsion. Furthermore, any person expelled from the Program will not be eligible for any refund from MOTL; must return to Australia immediately at their own expense unaccompanied by a representative of MOTL; and must immediately re-fund any financial assistance provided to them by MOTL. In case of expulsion, all parties (including parents/guardians, school principals and MOTL representatives in Australia) will be immediately notified.

RELIGIOUS POLICY

Please note that MOTL Australia follows a modern Orthodox halachic code of practice with definite consideration of pluralistic codes with regard to tefilla. Any breaches of this halachic policy will result in appropriate disciplinary action.

Kashrut

Kosher food is served on all flights. Purchase of non-Kosher food items will not be permitted at any of the airports.
Participants should bring with them Kosher snacks if they believe they might need same during stop-overs at foreign airports.
All meals in Poland and Israel are strictly kosher. Food in Poland has been flown in from Israel. A Mashgiach supervises distribution of all meals.
No food is to be purchased in Poland.

Tefillah

Services are compulsory every morning. An Orthodox minyan combined with elements of alternative spiritual practice will be followed.

Shabbat

Shabbat is observed and upheld.
Attendance at Shabbat services is compulsory.

APPLICANT’S AND PARENT’S STATEMENTS

I,:

I hereby also certify that the Medical History Form and all other forms that my child and / or I have filled in are complete and comprehensive and that it has been filled out in total good faith and transparency. I fully realise that any condition, mental or physical, that is found to have originated prior to my child’s departure, and which is not described truthfully and in full on the Medical History Form or in an accompanying letter prior to departure, will be due cause for my child’s return from overseas at my own expense. If treatment is needed for these undeclared pre-existing conditions in the country my child is visiting, this will also be at my own expense. Any pre-existing illnesses must also be filled in on the “Pre Existing Illnesses Form” in the Insurance Policy that will be taken out on my child’s behalf.

Furthermore, I herby also certify that March of the Living Australia and/or its representatives have neither responsibility nor liability arising from such a pre-existing condition. Furthermore, I hereby certify that all medication that my child regularly takes is detailed in the Medical History Form.

Furthermore, I herby also certify that March of the Living Australia and/or its representatives have neither responsibility nor liability arising from such a pre-existing condition. Furthermore, I hereby certify that all medication that my child regularly takes is detailed in the Medical History Form.

I,:

I hereby also certify that the Medical History Form and all other forms that I / my parents have filled in are complete and comprehensive and that it has been filled out in total good faith and transparency. I fully realise that any condition, mental or physical, that is found to have originated prior to my departure, and which is not described truthfully and in full on the Medical History Form or in an accompanying letter prior to departure, will be due cause for my return from overseas at my own expense. If treatment is needed for these undeclared pre-existing conditions in the country I am visiting, this will also be at my / my parents' own expense. Any pre-existing illnesses must also be filled in on the “Pre Existing Illnesses Form” in the Insurance Policy that will be taken out on my behalf.

Furthermore, I herby also certify that March of the Living Australia and/or its representatives have neither responsibility nor liability arising from such a pre-existing condition. Furthermore, I hereby certify that all medication that I regularly takes are detailed in the Medical History Form.