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Bar Mitzvah Club Registration

Bar Mitzvah Club Registration

Bar Mitzvah Club.jpg

Registration form

Bar Mitzvah Boy:
Boys Last Name

First Name

Hebrew Name

E-mail

Date of Birth:
MM/DD/YYYY

Time (morn. or eve.)

Grade / School

Hebrew School

Parents:
Parents Name

Parents Hebrew Name

Address

E-mail

Home #

Work #

Cell #

 

Any conversions in the family

Cost:
$180 per club member (Includes all sessions, activities and food)

Payment:
Amex Mastercard Visa Discover

$ Total amount

Card Number

Expiration Date (MM/YYYY) - Must be filled out in this format

First Name on card

Last Name on card

CVV Security Code
What's This?

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Questions or comments

For information please contact us at
856-874-1500 or email
YK@thechabadcenter.org



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