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Family Fun Spring 2019 Registration Form
Please verify reCaptcha before submitting the form.
Note: All classes are for children accompanied by an adult. Space is limited and all classes will need a minimum of 6 children. Priority will be given to Temple Israel members.
*
How many children are you registering?
-- Select --
One
Two (20% discount for second child in same family)
*
Child(ren)'s Last Name
*
Child's First Name
*
Child's Gender
Please Select One
Male
Female
*
Second Child's First Name
*
Second Child's Gender
Please Select One
Male
Female
*
Birthdate
Allergies, Food Restrictions, Health Considerations, etc.
Child(ren)'s Address
*
Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip
*
Home Phone
Parent / Guardian Info.
*
Last Name
*
First Name
*
Mobile Phone
*
Email Address
*
Synagogue Affiliation
Please Select One
Temple Israel
Other
None
Accompanying Adult
*
Same as Parent/Guardian (above)?
Please Select One
Yes
No
*
Accompanying Adult's Last Name
*
Accompanying Adult's First Name
*
Accompanying Adult's Cell Phone
*
Accompanying Adult's Relationship to Child
Classes
(Please select the number of children attending)
*
Mondays - Temple Tots
Please Select One
Not Attending
Temple Israel Member ($360)
Non-Member ($540)
18 weekly sessions, 1/14/19 – 6/3/19
*
Wednesdays - Temple Tots
Please Select One
Not Attending
Temple Israel Member ($380)
Non-Member ($570)
19 weekly sessions, 1/16/19 - 6/5/19
*
Thursdays - Challah to Hamantashen
Please Select One
Not Attending
Temple Israel Member ($540)
Non-Member ($720)
18 weekly sessions, 1/17/19 – 6/6/19
*
Fridays - Baby Bunch & Beyond
Please Select One
Not Attending
Temple Israel Member ($224)
Non-Member ($384)
16 weekly sessions, 1/25/19 - 5/31/19
*
Fridays - Temple Tots
Please Select One
Not Attending
Temple Israel Member ($340)
Non-Member ($510)
17 weekly sessions, 1/18/19 - 5/31/19
*
Mondays - Temple Tots
Please Select One
Not Attending
Temple Israel Member ($648)
Non-Member ($972)
18 weekly sessions, 1/14/19 – 6/3/19
*
Wednesdays - Temple Tots
Please Select One
Not Attending
Temple Israel Member ($684)
Non-Member ($1026)
19 weekly sessions, 1/16/19 - 6/5/19
*
Thursdays - Challah to Hamantashen
Please Select One
Not Attending
Temple Israel Member ($972)
Non-Member ($1296)
18 weekly sessions, 1/17/19 – 6/6/19
*
Fridays - Baby Bunch & Beyond
Please Select One
Not Attending
Temple Israel Member ($403)
Non-Member ($691)
16 weekly sessions, 1/25/19 - 5/31/19
*
Fridays - Temple Tots
Please Select One
Not Attending
Temple Israel Member ($612)
Non-Member ($918)
17 weekly sessions, 1/18/19 - 5/31/19
Photography / Video / Website Permission
*
Permission to use photographs:
Please Select One
You have my permission to use videos and photographs of my child (while enrolled in our classes or camps) for use in your catalog, Facebook, website, & advertising literature
No, you do not have my permission to use videos and photographs of my child
Thu, April 18 2024
10 Nisan 5784
Thu, April 18 2024 10 Nisan 5784