Kavanah Registration Form 2025-2026

For Jewish high school students ready to take action! Teens plan and lead service projects, learn about advocacy, meet local and state leaders, and participate in a trip to the Massachusetts State House in Boston. There will be four sessions between autumn and spring; exact program dates will be chosen with participants input to ensure accessibility.

Cost: We ask for a one-time $54 donation per family to the JFS program of your choice. No one will be turned away for inability to donate. Go to our website to donate or click here
Participants Full Name*
Participant's Age; School Attending; Grade*
Participants Phone Number*
Participants Email Address*
example@example.com
Participants Home Address *
Street, City, State & Zip
Special Needs and Accommodations: Do you have any special needs or require accommodations? If yes, please specify? If no, write N/A.*
Examples might include dietary restrictions, allergies, mobility needs, etc.
Participant's Availability: Before we finalize our schedule, we wanted to consult all participants about availability. Please list any dates between October 2025 and April 2026 that would not work for you.*
Participants Referral Source: How did you hear about this program?*

Participant's Goals: As you think about joining this program, what are you most hoping to accomplish?*
Participants Interests: What inspired you to register for this program? For instance, is there an issue you feel strongly about, a cause for which you would like to advocate or a topic you would like to explore further?*
Participant's Promise: I commit to attend all meetings barring an unforeseen emergency event*

Yes, I commit to attending all scheduled meetings
Parent/Guardian 1 Full Name*
Parent/Guardian 1 Relationship to Children*
Parent/Guardian 1 Phone number*
Parent/Guardian 1 Email Address*
example@example.com
Parent/Guardian 1 Home Address (if different from the participant)*
(Street, City, State, & Zip)
Parent/Guardian 2 Full Name
Parent/Guardian 2 Relationship to Children
Parent/Guardian 2 Phone number
Parent/Guardian 2 Email Address
example@example.com
Parent/Guardian 2 Home Address (if different from the participant)
(Street, City, State, & Zip)
Parent/Guardian Media Release: As parent/legal guardian, I give Jewish Family Service (JFS) permission to use my child's likeness (photo, video, etc for JFSWM publications, promotions, website, press releases, or other purposes. I agree. I disagree; do not use my child's image.*

I agreeI disagree; do not use my child's image
Parent/Guardian Waiver: I understand there are risks, including travel to Boston, and agree to release and hold harmless JFS, its employees, and volunteers ('Covered Parties') from any claims of injury, illness, or damages.*

Yes, I agree to release and hold harmless JFS, its employees, and volunteers ('Covered Parties') from any claims of injury, illness, or damages.
* Parent/Guardian Permission: As parent/legal guardian, I give permission for my child to participate in program*

Yes, I give my child permission to participate in this program.
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