Bat Mitzvah Club Registration

Note: If your child is currently enrolled in Hebrew School at Chabad of Calabasas, no need to fill out this entire form. Please provide the child's name and your names and sign the bottom.

Child's Information

Child's Name

Child's Hebrew Name

Birthday

School Attending

Grade

Family Information

If your daughter is enrolled in Chabad of Calabasas Hebrew School, you can skip the "Family Information" section and go to the "Parents Contact" section.

Are all the child's biological parents and grandparents Jewish?

YesNo

If no, please explain:

Have there been any conversions or adoptions in the family?

YesNo

If yes, please explain:

Parents Contact Information

Father's Name

Mother's Name

Preferred Address

City/Zip

Father's Cell Phone #

Mother's Cell Phone #

Preferred Email Address(es)

Emergency Contact (other than yourself)

Relationship to you

Home Phone #

Cell Phone #

Does your child(ren) have any allergies (food, medication etc.) that we should be aware of?

Registration Fee: $325

Fee DOES NOT include "Girls Night Out", Field Trip, or Shabbaton. These can be attended individually and will be charged separately.

Schedule and activities subject to change.

***

In the event of an emergency, Chabad of Calabasas has my permission to arrange for any necessary first-aid or care by a licensed physician/first-aid worker. Chabad of Calabasas has my permission to use my child(ren)’s photo in its publicity materials.

I have completed the Registration Form and the information submitted is true and accurate to the best of my knowledge. I have enclosed my payment.

Electronic Signature