BMC Registration Form

Bat Mitzvah Club Registration Form

For girls in 6th grade. Membership or affiliation is not required. The cost for Bat Mitzvah Club is $200 for the school year (Sep - April). Please contact Leah Levin Leah@Jewishballantyne.com with any questions. Meetings will take place at the Ballantyne Jewish Center 8632 Bryant Farms Rd.
Child 1 Name

First NameMiddle NameLast Name
Hebrew Name
Child 1 School and Grade
Child 1 Birth Date

MonthDayYear
Parent 1 Name
Parent 1 information
Parent 2 Name
Parent 2 Information
Any allergies or health issues we should be aware of?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent email
Parent Phone
Format: (000) 000-0000.
Additional Comments
Total Amount:

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USD
Should be Empty:

Bat Mitzvah Club Registration Form