DOROT’s B-Mitzvah Experience Registration

DOROT’s B-Mitzvah Experience Registration
Thank you for your interest in DOROT’s B-Mitzvah Experience!

This program is for youth who will have a B-Mitzvah between September 2025 and March 2026. Space is limited.
Youth Volunteer Name*

First NameLast Name
Youth Volunteer Birth Date*

MonthDayYear
When is your B-Mitzvah?*
Grade

5th6th7th
Name of School*
Type of School*

PublicPrivateCharterIndependentOther
Gender*
Gender if not listed above
What Pronouns do you use

she/her/hershe/him/histhey/them/theirsOther
Parent/Guardian 1 Name *

First NameLast Name
Parent/Guardian 1 Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone # *
Secondary Phone #
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Email
example@example.com
Primary Phone #
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is there anything you would like us to know about your child?
I heard about DOROT's BMitzvah Program from:*

DOROT emailDOROT websiteWebsite SearchSynagogueChildren’s SchoolA friend/family memberDugmahOther
DOROT's Terms of Service

DOROT prides itself on providing quality programs and on our efforts to ensure the safety and well-being of volunteers and older adults. As a DOROT Parent, I accept and will assist my child in adhering to the following standards of behavior when engaged in volunteer activities. I understand that DOROT may terminate my childs volunteer engagement at any time for any reason including failure to follow these guidelines.

My child will:
- Participate in required training programs, follow all rules and use the recommended policies and procedures;
- Adhere to all local, State and Federal laws and behave with the highest level of professionalism and integrity in all of their interactions with clients, staff and other volunteers;
- Preserve the confidentiality of information about program participants that has been entrusted to them;
- Attend all sessions, Sundays, 4:00-5:30 PM March 2 & 9; April 6 & 27; May 4 & 18 at DOROT, 171 W 85th St, NYC (some sessions may be off site)
I agree to DOROT's Terms of Service for volunteers. *

Yes
Please check your responses carefully for accuracy. You will not be able to revise this form after submission.
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DOROT’s B-Mitzvah Experience Registration

DOROT's Terms of Service