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Mitzvah Month: Bolton Street 12/17
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Mitzvah Month: Bolton Street 12/17
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Where do you live?
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-- Please Select --
Canton
Charles Village
Eldersburg
Federal Hill
Fells Point
Finksburg
Hampden
Highlandtown
Hunt Valley
Lake Walker
Locust Point
Lutherville-Timonium
Mount Washington
Owings Mills
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Pikesville
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Sparks
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Westminster
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Other
Other
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Which of the following best describes your current life stage (please check all that apply):
Adult 22-30 years old
Parent of Young Children (0-9)
Adult 31-45 years old
Parent of Tweens (10-13)
Adult 46-60 years old
Parent of Older Children (14-21)
Adult 61-75 years old
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Including yourself, how many people are you registering?
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Additional Participant #1
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How is this person related to you?
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Spouse
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Additional Participant #2
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Email
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How is this person related to you?
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Spouse
Child
Grandchild
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Friend
Additional Participant #3
Name
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How is this person related to you?
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Spouse
Child
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Additional Participant #4
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How is this person related to you?
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We are eager to learn more about you so that we can best serve you and support a diverse, inclusive and vibrant Baltimore Jewish community. These questions are optional, please answer only what you are comfortable sharing.
Do you identify as any of the following? (select as many as apply):
Leave blank if none apply
Deaf Adult
Descendant of Holocaust Survivors
Individual with Disabilities
Israeli
Jew of Color
LGBTQ+
New to Baltimore (less than 5 years)
Parent of a Child with Disabilities or Special Needs
Parent of an Adult with Disabilities
Russian Speaking
Single Parent
Widowed
Other
How do you describe your Jewish Identity? (select as many as apply):
Conservative
Cultural
Jew by Choice
Just Jewish
Modern Orthodox
Multifaith Household
Orthodox
Reconstructionist
Reform
Secular
Spiritual
N/A- I’m not Jewish
Other
Photo Permission
I give my permission to have my photograph used by The Network and The Associated Jewish Federation of Baltimore and its agencies. My agreement on this form gives photography release rights to The Network and The Associated Jewish Federation of Baltimore and its agencies. This release pertains to print as well as electronic media, including brochures, advertisements, annual reports, the website and other materials used to promote The Network and The Associated Jewish Federation of Baltimore and its agencies and constituent agency programs to the community. This release excludes third party media, state, and corporate security from the waiver.
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Liability Release (all participants)
I release and hold harmless The Network and THE ASSOCIATED: Jewish Federation of Baltimore, its affiliates, officers, employees and agents from and against all claims, damages, liabilities, losses and expenses actually incurred, arising out of any personal injury or property damage resulting from participation in any activity. This release shall be binding on my family, heirs, executors, administrators, personal representatives and guardians.
Yes
No