Teva Tuesdays: Adamah Adventures Nature Club

Campaign ID

TIer-B Program ID

Please use this form to register one child at a time. If you plan to register more than one child in your family, contact Julie Rosenbaum (julie.rosenbaum@adamah.org) for a sibling discount code.

About You (Parent/Guardian)

Salutation

Adult First Name

Adult Middle Name

Adult Last Name

Email Address

Mobile Phone

Birth Year

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

Yes

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

Yes

Basics About Your Child

Child First Name

Child Middle Name

Child Last Name

Birthdate

Child's grade level

Please let us know anything that will be helpful in fully supporting your child(ren) during Adamah Adventures Nature Club (behavioral, social, emotional, physical)

Full Name

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

Which of the following best describes you?

Please describe how you identify racially

What is your gender identity?

Please describe your gender

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)

Payment

Cost: $180

The fee covers the full 8 week fall series (plus a make-up date if needed). We are able to offer this subsidized rate due to the generosity of Adamah supporters. Please reach out to Julie (julie.rosenbaum@adamah.org) to discuss additional financial aid needs. Siblings/additional family members registered also receive 30% off.

Standard fee

Discount Code

Discount Proportion

Payment Amount for SF Mapping

Discount Amount for SF Mapping

Optional donation

Please consider a donation to support our work and help make our programs accessible to all. We welcome donations of all sizes!

Total Amount

Credit Card Information

Card Number

CVV

Billing Street Address

City

State

Zip Code

Country

Please click the button below only once. If you encounter an error that you cannot resolve, please reach out to us at data@adamah.org.

Contact Information