Congratulations on your acceptance into the Young Philanthropy Fellows!

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View our Preliminary Schedule
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Register below to accept your spot:

PARTICIPANT INFORMATION

Please complete all requested fields below:
Student Name(Required)
Any foods served will be hekshered or Kosher-style, but please indicate if hekshered is required.
This information is private and will only be shared with medical professionals in case of emergency. Teens are expected to take medication on their own. Medication, over-the-counter and prescription, cannot be shared between teens.
Example: Tylenol, Aspirin, Midol, Tums, Advil, etc.
Accessibility: To request accommodations, please check this box and a member of our team will contact your parent/guardian.
Atlanta Jewish Foundation is happy to provide any required accommodations so that you may fully participate in this program. To request accommodations, please check this box and a member of our team will contact you.

SESSION SCHEDULING

The preliminary program schedule is as follows:

Family Orientation: December 16th, 6:00-7:00pm

Session 1: January 19th, 1:30-3:30pm

Session 2: February 2nd, 1:30-3:30pm

Session 3: February 23rd, 1:30-3:30pm

Session 4: March 16, 1:30-3:30pm

Session 5: March 27th, 5:30-8:00pm

WAIVER

This is to indicate that our child has our permission to participate in this Atlanta Jewish Foundation program. While we expect the Atlanta Jewish Foundation staff to take necessary health and safety precautions, we understand that the Atlanta Jewish Foundation is NOT responsible for illness or accidents during or in transit to or from the destination of the activities. We relieve the Atlanta Jewish Foundation of liability should an accident occur. The Atlanta Jewish Foundation assumes no liability for injury or damages arising from the results of participation in this Atlanta Jewish Foundation program unless due to willful fault or gross negligence on the part of the Atlanta Jewish Foundation. All activities present certain inherent risks and hazards which the participant is urged to consider and which the participant assumes. I certify that my child is in good health and may participate in all activities. I hereby approve and certify my child's participation in this program and consent to emergency medical treatment for my child on my behalf. To the best of my knowledge, there are no physical or other conditions which will interfere with my child's participation. In the event that I cannot be reached in an emergency, I hereby give permission to the Atlanta Jewish Foundation staff to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child as named above.(Required)

MEDIA RELEASE

I do hereby agree to the following as a program participant of Young Philanthropy Fellows and/or a parent/guardian of the former participant. In connection with the participation in this Atlanta Jewish Foundation activity, I authorize the Atlanta Jewish Foundation to take, use, and publish photographs, video or audio recordings, or quotations from interviews which may be used for editorial, fundraising, and/or promotional and advertising purposes and in any manner and medium; and to alter and composite the same without restriction and without inspection or approval. I agree that there is to be no financial compensation for said use or publication, and hereby release the Atlanta Jewish Foundation and persons functioning under its authority from all claims and liability relating to the same. I understand that to revoke this photo/video/testimonial release, I must do so in writing to kberinhout@jewishatlanta.org.
Please upload a photo of yourself where your face is clearly visible (it doesn’t have to be a professional headshot).
Accepted file types: jpg, jpeg, png, gif.
This photo may be used on our website and in news articles.

Questions? Contact Kaylin Berinhout at kberinhout@jewishatlanta.org

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