Jewish Family Service Corps Registration Form 2025-2026

This Jewish service and education program invites families with elementary and middle school students to learn, serve, and grow together.

Rooted in the core values of Judaism, the program gives parents and children the chance to work side by side on meaningful, hands-on volunteer projects that support local families in need.

Together, families strengthen their own ties while making a real difference in the community.

Parent/Guardian 1 Full Name*

Parent/Guardian 1 Relationship to Children*

Parent/Guardians 1 Phone Number*

Parent/Guardian 1 Email Address*

example@example.com

Parent/Guardian 1 Address*

Street, City, State, Zip

Parent/Guardian 2 Full Name

Parent/Guardian 2 Relationship to Children

Parent/Guardians 2 Phone Number

Parent/Guardian 2 Email Address

example@example.com

Parent/Guardian 2 Address

Street, City, State, Zip

* Children's Information Child 1: Full Name; Age; School Attending; Grade Level*

Children's Information Child 2: Full Name; Age; School Attending; Grade Level

Children's Information Child 3: Full Name; Age; School Attending; Grade Level

Children's Information Child 4: Full Name; Age; School Attending; Grade Level

Does any JFSC family member have any special needs or require accommodations? If yes, please specify?*

Examples might include dietary restrictions, allergies, mobility needs, etc.

Emergency Contact Full Name*

Emergency Contact Relationship to Family*

Emergency Contact Phone Number*

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.*

Referral Source: How did you hear about this program?*