Youth Programs Discovery Night

Youth Programs Discovery Night - Fire-Building

Registration is free. Donations are welcome.

Registrant Information

Salutation

First Name

Middle Name

Last Name

Email Address

Birth Year

Zip Code

Optional Demographic Questions

We strive to make our programs as diverse, equitable, and inclusive as possible. Knowing more about you helps us do that. We acknowledge that identity is complex and that your identity may not fit into these categories. The following questions are optional, but strongly encouraged.

How do you identify religiously?

Please describe how you identify religiously

What is your Jewish ethnicity?

Please describe your Jewish ethnicity

What is your gender identity?

Please describe your gender

Which of the following best describes you?

Please describe how you identify racially

Child Information

First Name

Middle Name

Last Name

Birth Year

Fall 2026 Grade in School

Does this child have any siblings who are currently or were previously enrolled in B’hootz, B’naiture, Shomrim, or Neshama Quest?

YesNo

By registering, you consent to receive program-related emails. Would you like to be added to the Adamah SF newsletter list?

Yes

Would you like to be added to the general Adamah newsletter list?

Yes

Adamah Photography / Social Media Waiver

There may be photography at this event. We may use photos on our website, in digital promotions, or in print materials. Unless we get your direct consent, we will not use your name along with the photo. If you do not want to be photographed at all, please speak to the lead staff at the event upon your arrival, and take care to not be part of group photos.

I consent to the publicity release above (for myself and all minors for whom I am registering at this time)

Safety and Liability Waiver

I, the above Participant or parent/guardian of the above Participant, ACKNOWLEDGE that the Participant's choice to participate in the Program is knowing, voluntary, and made for their personal enjoyment. I hereby certify that the Participant is physically fit and capable of participating in this Program and that they do not suffer from any condition, sickness or disease that would impair their ability to participate in the Program or that presents any danger to their wellbeing as the result of such participation. I assume all the foregoing risks and fully accept personal responsibility for all expenses, medical or otherwise, following any such damages, injury, permanent disability or death. I RELEASE and DISCHARGE Adamah and its directors, officers, members, employees, agents, successors and assigns, from and waive any and all liability to myself, heirs and next of kin or any other person, for any and all claims, demands, losses, or damages, including death or damage to property, which, in whole or in part, arise from, relate to or are alleged to arise from or relate to the Program, any and all related events and activities in which the Participant takes part. I recognize that the Participant has an important personal obligation to conduct themselves in a manner compatible with local laws and regulations, and will abide by all such laws, regulations, standards and policies and promise to act responsibly and with respect for persons and property.

I agree to terms of the safety and liability waiver (for myself and for all minors for whom I am registering at this time)

While this program is free, please consider supporting our work with a tax-deductible donation of $18-72.

Optional donation

Total Amount

Credit Card Information

Card Number

CVV

Billing Street Address

City

State

Zip Code

Country

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