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Junior Youth Group (JYG) Registration 2020-2021
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Junior Youth Group (JYG)
Registration 2020-2021
Welcome to Junior Youth Group (JYG). This program is open to all middle schoolers grades 6th-8th.The registration fee covers membership for the 2020-2021 school year monthly programs. Additional programs offered (such as sports outings) may incur an additional fee.
This program is made possible by a generous grant from Memphis Jewish Federation.
If you have any questions, please contact
Carly Abramson
, (901) 937-3130.
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Teen First Name
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Last Name
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Teen Email
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Teen Cell
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What academic school does your teen attend?
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What grade is your teen in?
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T - Shirt Size
Please Select One
XS
S
M
L
XL
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What is your teen's birthday?
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Does your teen have food restrictions?
Please Select One
Yes
No
If so, what are the restrictions?
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Address
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City
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State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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ZIP
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Parent/Guardian First Name
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Parent/Guardian Last Name
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Parent/Guardian Relationship to teen
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Parent/Guardian Email
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Parent/Guardian Cell Phone
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How many Emergency Contacts would you like to list?
Please Select One
One Contact
Two Contacts
*
Contact - First Name
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Contact - Last Name
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Contact - Email
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Contact - Cell Phone
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Contact - First Name
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Contact - Last Name
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Contact 2 - Email
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Contact 2 - Cell Phone
Any pertinent medical information concerning your child:
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I hereby give permission for a JYG board member to deliver supplies to my home address for certain JYG events. I understand that I will be given advance notice of all deliveries and that all deliveries will be contactless.
Please Select One
Yes
No; I will provide my child with the necessary supplies.
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I hereby give permission for my child to attend JYG field trips for the 2020-2021 school year. I will be given advance notice of all JYG field trips and field trip agendas. In the event of an emergency involving my child, I give JYG permission to seek and render essential medical assistance.
Please Select One
Yes
No
*
I grant to Temple Israel, its representatives and employees the right to take photographs of me, my property, and my child in connection with JYG. I authorize Temple Israel, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Temple Israel may use such photographs of me or my child with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
Please Select One
Yes
No
*
The information in this form is not to be used for business purposes. However, Temple Israel may share your information with other Jewish organizations.
Please Select One
Yes Temple Israel may share my information with other Jewish organizations
No Temple Israel may NOT share my information with other Jewish organizations
Total
Thu, March 28 2024 18 Adar II 5784