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 for the occasion and important discussions towards becoming Bat Mitzvah.
Cost for Bat Mitzvah Girls Club participation: $108 (for all three 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 NameLast Name
Hebrew Name
Age*
Birth Date*
MonthDayYear
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 CodePhone Number
Father's Name*
First NameLast Name
Father's Cell*
Area CodePhone Number
Father's Email
Mother's Name*
First NameLast Name
Mother's Cell*
Area CodePhone Number
Mother's Email*
Maternal Grandmother born Jewish?*
Mother born Jewish?*
YesNo
Emergency Information
Emergency Contact 1*
First NameLast Name
Phone Number*
Area CodePhone 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!*
Bat Mitzvah Girls Club - $108
Total
$0.00

Payment*

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Chabad Hebrew School activities and that these pictures may be used for marketing purposes.
*
I agree
Name
First NameLast NameInitial
Date*
MonthDayYear
We look forward to a wonderful year of learning and growth!
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Bat Mitzvah Girls Club