Hebrew School Bat Mitzvah Club 2023

Child Name*

First NameLast Name
Hebrew Name
If known
Grade*
Birth Date*

MonthDayYear
Date
MorningEvening
School*
YesNo
YesNo
Who?*
If there was a conversion - who was the Rabbi?*
Parent Information
Mother Name
Mother Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Father Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Father Name

First NameLast Name
Parent Email *
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payment Information: $450 for the year

Please note: No one will be turned away due to lack of funds. Please submit this form and contact Hadassah for financial assistance: 516-458-3694

If you have already given the $50 deposit please use code DEPOSIT at checkout to have the $50 deducted
I would like to pay with a credit cardI will be sending in a cash / check

Bat Mitzvah Club - Hebrew School

$450.00

Enter coupon

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Thank you so much for registerting for our Bat Mitzvah program! Your child will thank you!

Hadassah will be in touch with you with more information - if you have any questions feel free to reach out: 516-458-3694
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Parent Information