2023 MLK Day WAIT LIST – Signature Site Afternoon – Macks Jewish Connection Network

Are you registering as an individual/family or a leader of a group/organization (synagogue, school, troop, etc.)?

Individual/Family

Group Leader

Individual/Family Information

First Name *

Last Name *

Address *

Address

City

State/Province

Zip/Postal

Preferred Phone Number *

E-mail Address *

Will you be bringing additional volunteers? *

Yes

No

Group Information

Group Name/Affiliation

Group Contact Person

First

Last

Group Contact Person Email *

Number of Volunteers in Group

Does your group include volunteers under the age of 18?

Yes

No

Volunteer groups including youth will be sent a permission slip to be completed by the parent/guardian of each child.

Will the group contact above be the day-of contact for this group? *

Yes

No

Day Of Contact Name

First

Last

Day Of Contact Email

Day of Contact Phone Number

Additional Volunteers

First Name *

Last Name *

Is this volunteer under 18? *

Yes

No

What is their age? *

Add Remove

Do you (or any member of your family) require special accommodations? If so, please explain:

Liability Information

For all volunteers: I release and hold harmless THE ASSOCIATED: Jewish Community Federation of Baltimore, its affiliates, officers, employees and agents from and against all claims, damages, liabilities, losses and expenses actually incurred, arising out of any personal injury or property damage resulting from participation in any activity. This release shall be binding on my family, heirs, executors, administrators, personal representatives and guardians. *

I Agree

For volunteers under age 18: I represent that I am the custodial parent or legal guardian of the above registered child(ren), and intend THE ASSOCIATED and its affiliates, officers, employees and agents rely on this representation. *

I Agree

N/A

I give my permission to have my photograph used by THE ASSOCIATED: Jewish Community Federation of Baltimore. My agreement on this form gives photography release rights to THE ASSOCIATED. This release pertains to print as well as electronic media, including brochures, advertisements, annual reports, the website and other materials used to promote ASSOCIATED and constituent agency programs to the community. This release excludes third party media, state, and corporate security from the waiver. *

I Agree

I Do Not Agree

2023 MLK Day WAIT LIST – Signature Site Afternoon

Monday, January 16
Beth El Congregation
(8101 Park Heights Avenue, Pikesville, 21208)
1:00-3:00 p.m.

Individual/Family Information

Group Information

Additional Volunteers

Liability Information

Contact Info

2023 MLK Day WAIT LIST – Signature Site Afternoon

Monday, January 16 Beth El Congregation (8101 Park Heights Avenue, Pikesville, 21208) 1:00-3:00 p.m.

Individual/Family Information

Group Information

Additional Volunteers

Liability Information

Contact Info

We've moved!

Discover the Jewish experiences, connections, and resources waiting for you at the Jewish Connection Network!

This site will close down at the end of February 2024.

Monday, January 16
Beth El Congregation
(8101 Park Heights Avenue, Pikesville, 21208)
1:00-3:00 p.m.

Discover the Jewish experiences, connections, and resources waiting for you at the
Jewish Connection Network!