Repair the World Programs
Event Information
Private Event
Yes
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 an adult registering myself, or myself and other non-family members
I am a parent and/or guardian registering myself, my child(ren) and/or spouse for this program
I am a parent and/or guardian registering my child(ren) for this program
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?
Yes
No
Select the number of adults being registered
Please select...
1
2
Select the number of children being registered
Please select...
1
2
3
4
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
Adult Info (Emergency Contact)
First Name
Last Name
Pronouns
Email
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 participants who are under the age of 18
Additional Adults
First Name
Last Name
Pronouns
Email
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
Email
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 Info (Emergency Contact)
First Name
Last Name
Pronouns
Email
Cell Phone
Zip Code
Registered Particpant
Yes
Adult 2 Info
First Name
Last Name
Pronouns
Email
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
Email
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
Email
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
Email
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
Email
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
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.
Hidden Fields
# of People Registered
Registration Cap (Campaigns)
Registration Option
Venue Id
Registered Shift
Registration Cap (Registered Shift)
Spots in Registered Shift
Program Zoom Link
Program Time Zone
Virtual?
Yes
Context
MLK
Alternative Break
Cocktails with a Conscience
Edu Crew
Expansion
Family Engagement
Farm Crew
Fundraising
Giving Circle
Peer Corps
Turn the Tables
Art/Gallery
Film Screening
Teens
VolunTeams
Tweens