Repair the World Programs

Event Information

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Summer Teen Service Corps 2023 Interest Form

Want to spend your summer immersing yourself in your community through service and exploration? Join Repair the World for our Teen Service Corps! Spend three or six weeks with a direct service partner  in Brooklyn or Harlem and learning about the various justice areas we specialize in here at Repair. Our program also includes field trips and creative reflection to deepen our learning. The first session will run from June 29th-July 20th and the second session will be from July 25th-August 10th. This program is open to teens in high school of all faiths, we can't wait to have you join us! Sign up here to join a virtual info session or click here to read more: rpr.world/teensummer

Start Date

05/01/2023

Venue Location

,

Spots Remaining

36

I am a parent registering my children and/or spouse for this programI am an adult registering myself, or myself and other non-family members

Program Information

Program Name

Event Description

Want to spend your summer immersing yourself in your community through service and exploration? Join Repair the World for our Teen Service Corps! Spend three or six weeks with a direct service partner  in Brooklyn or Harlem and learning about the various justice areas we specialize in here at Repair. Our program also includes field trips and creative reflection to deepen our learning. The first session will run from June 29th-July 20th and the second session will be from July 25th-August 10th. This program is open to teens in high school of all faiths, we can't wait to have you join us! Sign up here to join a virtual info session or click here to read more: rpr.world/teensummer

Start Date

Start Time

Spots Left

Venue

,

Program has shifts?

YesNo

Select the number of adults being registered

Select the number of children being registered

ERROR:

Shift

Spots Left

Register

Spots Open?

Yes

Space for family?

Registration Cap (Shift)

Registration Cap (Selected Shift)

ERROR:

Multiple Shifts Selected Error Message

Main Registrant Information

The individual registered in this section of the form will be the one to receive a confirmation email containing the names of all individuals they registered.

First Name

Last Name

Pronouns

Cell Phone

Zip Code

Registered Particpant

Yes

You may register up to 8 additional participants.

I'd like to register additional adults

I'd like to register additional children

Address

Address information is for main registrant only, does not need to apply to all participants

Street Address

City

State

Additional Adults

First Name

Last Name

Pronouns

Sharing an email for this participant ensures that everyone registered receives all communication for this program. You may leave this field blank if this participant does not have an email address

Cell Phone

Zip Code

Registered Particpant

Yes

Additional Children

All children must be accompanied by a parent, guardian, or supervisor to attend Repair the World events.

First Name

Last Name

Pronouns

Sharing an email for this participant ensures that everyone registered receives all communication for this program. You may leave this field blank if this participant does not have an email address

Date of Birth (MM/DD/YYYY)

Registered Particpant

Yes

Adult 1 Info

First Name

Last Name

Pronouns

Cell Phone

Zip Code

Registered Particpant

Yes

Adult 2 Info

First Name

Last Name

Pronouns

Sharing an email for this participant ensures that everyone registered receives all communication for this program. Leave the field blank if you do not have this participant's unique email address

Cell Phone

Zip Code

Registered Particpant

Yes

Child 1 Info

First Name

Last Name

Pronouns

Sharing an email for this participant ensures that everyone registered receives all communication for this program. You may leave this field blank if this participant does not have an email address

Date of Birth (MM/DD/YYYY)

Registered Particpant

Yes

Child 2 Info

First Name

Last Name

Pronouns

Sharing an email for this participant ensures that everyone registered receives all communication for this program. You may leave this field blank if this participant does not have an email address

Date of Birth (MM/DD/YYYY)

Registered Particpant

Yes

Child 3 Info

First Name

Last Name

Pronouns

Sharing an email for this participant ensures that everyone registered receives all communication for this program. You may leave this field blank if this participant does not have an email address

Date of Birth (MM/DD/YYYY)

Registered Particpant

Yes

Child 4 Info

First Name

Last Name

Pronouns

Sharing an email for this participant ensures that everyone registered receives all communication for this program. You may leave this field blank if this participant does not have an email address

Date of Birth (MM/DD/YYYY)

Registered Participant

Yes

I indicate that I have read, understood, and agreed to the Release and Waiver of Liability and COVID-19 Waiver on behalf of all registrants listed in this form.

By submitting this form you consent to have your information shared with Repair the World and their partners.

It may take a some time for this form to process after you click Submit.

Please do not click Submit more than once.