Shabbat Walk Family Registration Form
Shul or Congregation you belong to:
How did you hear about Shabbat Walk?
Is this your first contact with Shabbat Walk?
SPOUSE/PARTNER (IF APPLICABLE)
Due to safeguarding regulations, we will need to carry out reference checks.
FAMILY MEMBERS IN HOUSEHOLD
Date of Birth:
Date of Birth:
Remove last child
EMPLOYMENT AND HOUSING
Full Time/Part Time:
If your spouse is employed, please state Occupation:
If your spouse is employed, please state Full Time/Part Time:
Type of housing:
ASSISTANCE BY OTHER ORGANISATIONS / AGENCIES
Are you currently being assisted by any other agencies (communal, local authority etc)?
If so, what help are you receiving?
Are you or a member of the family receiving any benefits?
Are there any factors (i.e. medical, accessibility issues) relevant to you or a family member?
Why do you need our assistance?
What kind of assistance do you think you need?
Playing with Children
Taking out special needs child
Days volunteer would be helpful (Please tick all days applicable)
Timings during day would be helpful (am or pm, please specify earliest and latest times that would work)
VOLUNTEER TYPE REQUIREMENT
This will help us with finding your volunteer
Gender of Volunteer:
Male or Female
Required religious level of volunteer:
Would you want a replacement volunteer if the regular one is not available?
What would you require the volunteer to do? (please detail as much as possible)
Any other comments?