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Register

  • Kivun Kids Club Registration Form 2021-22

  • Parents' Information

  • Child's Information

  • Emergency Information

  • Authorization

  • I hereby give permission for my child to be transported to and from field trips, and to participate in them in all Kivun activities. I understand that during the course of Kivun my child can be hurt. I accept the risk of possible injury and authorize any member of the Chabad of Bensonhurst staff to render any necessary first aid. Furthermore, in an emergency case, I hereby authorize Chana hertz or another staff member to have my child taken care of by a physcian or other medical person in any way the situation calls for. 

  • I give permission to Chabad of Bensonhurst and Kivun, and those authorized by Chabad, to take photographs and to make recordings of my children and my family, and to use them in original or modified form in all media now or hereafter known, with or without my name or information about me, for the promotion, public education, and/or fundraising activities of Chabad of Bensonhurst. 

  • Payment Options

    For other payment options, please call (347) 277-5040
  • Scholarships Available.

  • (If choosing to pay in 2 installments, the second payment will automatically be deducted on January 3rd.)

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    Billing Address
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