Summer of Service Registration Form

Summer of Service 2026 Registration Form

JTConnect Summer of Service is an unforgettable week of giving back, learning, and summer fun for teens! Taking place August 17–21, each day includes breakfast, meaningful learning, hands-on community service, lunch, and an exciting group activity. Teens have the opportunity to make a real impact through projects like planting trees, volunteering at food banks, and supporting local organizations, while also building friendships through fun activities such as pool parties and amusement parks. It’s a meaningful and memorable way to spend the last week of summer! Please use this form to sign your teen up for JTConnect's Summer of Service 2026. If you have any questions regarding the form or a need for scholarship please email info@jtconnect.org
Teen's Full Name

First NameLast Name
Teen's Nickname (if applicable)
Teen's Preferred Pronouns
Teen Shirt Size

Other
Teens Email (not affiliated with school)
example@example.com
Teens Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Birthday

MonthDayYear
Date
Teen's Anticipated High School Graduation Year
Name of School Currently Attending
Medical Information
Please describe any dietary needs (all food provided is certified kosher through approved Hartford Kashrut Commission vendors)
Please list any allergies your teen has (write N/A if none)
Name of Physician

First NameLast Name
Physician's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medications
Please list all medications, note if they will need to carry their medication with them during the day at SOS.
Health Insurance Carrier
Member ID #
Parent/Guardian 1 Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Relationship To Teen
Parent/Guardian 2
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship To Teen
Secondary Emergency Contact Information

Please add an additional emergency contact if parent/guardian cannot be reached.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Teen
Is there anything else that we should know about your teen for Summer of Service?
Signatures
The undersigned guardian/parent(s) of First Name Last Name give my consent and permission to their participation in Summer of Service on June 15-19, 2026. As a parent/guardian, I give my permission for my child to engage in all prescribed activities except as noted above. I release JTConnect and its agents from all responsibilities other than those directly related to the organized activity prescribed. If I cannot be reached in an emergency, I authorize the physician selected to provide care as necessary for the participant named above. Unless otherwise arranged, participants will meet each morning at the designated locations.
Parent/Guardian Signature
Click Here To Review Photo Release Form
Parent/Guardian Signature- I have read and agree to the Photo Release Form above.
Click Here To Review Code of Conduct

By my signature, I certify that I have read the above Code of Conduct. I will adhere to the program, observe the Code of Conduct, and conduct myself in a manner reflecting credit upon my community.
Teen Signature- I have read and agree to the Code of Conduct above.

Teens sign here.
Parent/Guardian Signature- I have read and agree to the Code of Conduct above.

Parent/Guardian sign here.

Payment

Please contact info@jtconnect.org with any questions regarding registration and available scholarships.

My Products

Summer of Service Full Payment

$425.00

Donation

If you would like to support our work, you may choose to make an optional donation. Your contribution is appreciated but not required to participate.

$18.00

Enter coupon

Total

Payment Methods
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty:

Summer of Service 2026 Registration Form

Medical Information

Parent/Guardian 1 Information

Parent/Guardian 2

Secondary Emergency Contact Information

Signatures

Payment

My Products