Volunteer Form

Name

GenderMaleFemale

Date of Birth

Email Address

Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

School Attending

Year Graduating High School

List Any Youth Groups With Which You Are Affiliated:

Please upload a picture of yourself

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Mother's Name

Mother's Mobile Phone

Mother's Email Address

Father's Name

Father's Phone

Father's Email Address

Medical Information

Volunteer's Legal Name

Any Presenting Medical Conditions or Allergies. If yes, please list medications and frequency.

Emergency Contact Name

Relationship to Volunteer

Emergency Contact Home Phone

Emergency Contact Cell Number

Doctor's Name

Doctor's Phone Number*

Medical Release Form

I hereby give consent to the administration of the Nagel Jewish Academy to take whatever medical measures they deem necessary, at my expense, for my child in the event of an emergency.

Date

Parental Signature

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I hereby permit my child to participate in all school activities, and to join in class and school trips on and beyond school properties and use any transportation selected by Maor Academy

Parental Signature

I give my teen permission to volunteer at all Maor events.

Parental Signature

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I hereby give permission for my child’s photographs/videos to be used in newsletters, local newspapers, Maor Website or for promotion of our program.

Volunteer Code of Conduct

• I understand that Maor Academy expects me to behave responsibly. • I agree to utilize my best judgement and sense of responsibility when spending time with my buddy. • I agree to respect privacy of all participants of Maor Academy• I understand that I am committing to volunteer 2 days per month.• If someone gets hurt or some other incident occurs while I am volunteering, it is my responsibility to immediately report the occurrence to the Maor Academy staff.• I understand that participation in the Buddy program is entirely voluntary.• I understand that community service hours will only be issued to my teen for hours submitted on a monthly basis through our app• I understand that community service hours will be submitted to my school if I request them, and that there is a 3-5 day processing time.

Volunteer Signature

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Please tell us the three best qualities you have:

Do you have a talent or a hobby that you might like to share with the kids?