Bat Mitzvah Girls Club Registration

Mazal Tov on the upcoming celebration of your child's Bat Mitzvah.According to Jewish tradition, a Bat Mitzvah reflects a major turning point in the life of a Jewish girl. As such, we believe very strongly that every girl should celebrate this milestone in a meaningful and traditional manner.

The Bat Mitzvah Girls Club offers three interactive and engaging lessons. The sessions include scrapbook making, a customized speech and gift for the occasion and meaningful discussions towards becoming a Bat Mitzvah.

Cost for Bat Mitzvah Girls Club participation: $200 (for all four sessions)

Please fill out ALL fields of this form. For any questions, call 347.277.5040
Bat Mitzvah Girls Club

For Girls Ages 11-12
Student Profile
Full Name*

First Name Last Name
Hebrew Name
Age*
Birth Date*

Month Day Year
Time of Birth* In Judaism the day begins at nightfall, so in order to determine the exact date of your Jewish birthday we need to know what time of day you were born.
School*
Grade Entering*
Hebrew Reading Proficiency

NoneSomewhatWell
Previous Jewish Education

YesNo
If yes, where?
Does your child have any learning disabilities? Please specify* (This information will help us better cater to the needs of your child.)
Parent Information

Address*

Phone Number*

Area Code Phone Number
Father's Name*

First Name Last Name
Father's Cell*

Area Code Phone Number
Father's Email
Mother's Name*

First Name Last Name
Mother's Cell*

Area Code Phone Number
Mother's Email*
Maternal Grandmother born Jewish? *
Mother born Jewish? *

YesNo
Emergency Information
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed*
Payment Information
Yes, I'd like to join!* Special Discount for students of Hebrew School of the Arts. Contact Rebbetzin Hertz 347.277.5040

Bat Mitzvah Girls Club - $200
Total

$0.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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Bat Mitzvah Girls Club