Shemesh Farms Pumpkin Smash

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

Age Confirmation (for liability purposes)

At the time of this program will you be over 18?

Yes, I will be 18 or olderNo, I will be under 18

The consents below must be affirmed by a parent or guardian:

Parent/Guardian Name

Parent/Guardian Phone Number

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 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 themself in a manner compatible with local laws and regulations, and will abide by all such 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)

Optional donation

This is event is free for everyone. Our work is made possible by our generous donors. If you are able to support, we suggest a donation of $18 per person. Any other amount is appreciated. Thank you!

Other Amount

Total

payment amount for SF mapping

Credit Card Information

Card Number

CVV