Adult Registration Form for Martin Luther King Jr. Day of Service 2020
This form should be filled out by volunteers ages 18 and up.
Email address *
I acknowledge that my participation in Martin Luther King Jr. Day of Service is voluntary and may result in personal injury or property damage. I understand and assume all risks relating to participation in this event and agree that Jewish Teen Initiative of Greater Boston (JTI) and its employees, directors, officers, agents, representatives, independent contractors, licensees and sponsors (collectively, the “Releasees”) shall not be responsible for any personal injury, property damage and/or other loss suffered as a result of my participation in any of the individual activities (an “Injury”). I understand by signing below, and in consideration of being permitted to participate in the volunteer activities, I forever release each of the Releasees from any and all liability arising from an Injury. *
Type your name to sign *
Your answer
I understand that my picture may be taken at this event, and that it may appear on the JTI website, social media or in a brochure *
First Name *
Your answer
Last Name *
Your answer
Home Address (address, town, state, zip code) *
Your answer
Participant's phone number
Your answer
Will you be attending with a teen, synagogue or organization? If so, please add their name here.
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Which activity would you like to help with? (Please check all that apply) *
Required
Do you wish to serve as an adult project leader, where you will help oversee a project and provide support to the teen project leaders? *
Are there any special medical or dietary concerns or limitations to your full participation in this program? (All information is completely confidential.) *
Your answer
Synagogue affiliation (if any) *
Your answer
I am willing to submit to a background check to work this event. (Answering "no" may disqualify you as a volunteer) *
Required
How did you hear about this event? *
Thank you for registering! We look forward to seeing you at Temple Shir Tikva, located at 141 Boston Post Road, Wayland, MA, at 12:00 PM, on Monday, January 20, 2020.
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