Batya Pool Party

Batya Pool Party

We Can't Wait to See You There! | 6:00pm-8:00pm | 6724 Westbrook Rd.
Participant's Name*

First NameLast Name
Will you attend the Batya Pool Party?*
Is this the Participant's first JEP event of 2024/2025?*
Birthday*

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Address*

Street Address

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Does the participant attend Hebrew School?*
Hebrew School*
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Does the participant have any allergies?
Please list participant's allergies:*
Important Information/Special Concerns:
Mother's Name*

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Mother's Email
Mother's Cell Phone Number

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Is mother's home address the same as participant?
Mother's Address

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Father's Name*

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Is father's home address the same as participant?
Father's Address

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Parents' Marital Status
Other:*
Does the participant have a stepparent?
Stepparent via
Stepparent's Name*

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Second Stepparent via
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Please list participant's siblings and ages:
Emergency Contact (if parents unreachable)*

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Relationship to Participant*
At Batya, we rarely charge for our weekly programs because we believe in creating meaningful experiences for everyone. Would you like to contribute a $13 donation to help cover the discounted tickets for our upcoming visit to the Bais Yaakov Exhibit?
I hereby give consent for my daughter to participate in this JEP event. I understand that JEP takes photos and videos during events and posts them to the JEP website and social media and give permission for my daughter’s photos to be included in promotional materials. I understand that if my child has a medical need, JEP will make a conscientious effort to notify my spouse or me. In the event that this is not possible, I give permission for JEP Girls of Maryland and its staff, or person designated, to make available to my child professional emergency medical care when such care is indicated. I give permission for my child to receive proper medical care by any doctor, nurse, paramedic, or member of a medical staff of a hospital.*

By checking this box and printing my name below, I am giving my consent.
Parent's Name*

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Date*

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