Summer Service Learning 2025 Registration

Participant

Address

Parent / Guardian

Shirt Size

Emergency Contact (if parent/guardian can't be reached)

 
As part of this program, photos and videos will be taken for marketing and promotional purposes.

Publicity Release Waiver

I hereby give consent to JASA to use, edit, and publish images and videos of my participating child for purposes of publication, promotion, advertising, printing, emailing, copying or web publishing. JASA may also photograph, videotape, and share content from my personal social media accounts on posts related to JASA and older adults.

I waive any right to inspect or approve the finished product or to receive compensation arising or related to the use of the photo wherein my likeness appears.
 
I have read and understand the above PR rights release. I affirm that I am at least 18 years of age.
Download Service Week Waiver form
Please download this file: Service Week Waiver, and upload the completed and signed file below, or email it to development@jasa.org. A completed waiver is required for participation.
Upload requirements