Registration Form
Registration Form
I would like to sign-up for:
Tuesday's 4:15pm (Nursery-Year 7)
Sunday's 9:45am (Nursery-Year 2)
GCSE Jewish Studies syllabus (Year 9 & 10)
Both/Undecided
I would like to sign up - How many children are you registering?
1
2
3
Child 1
First
Last
1 Hebrew name (if known)
1 Date of birth
/
MM
/
DD
YYYY
1 School and year attending
Child 2
First
Last
2 Hebrew name (if known)
2 Date of birth
/
MM
/
DD
YYYY
2 School and year attending
Child 3
First
Last
3 Hebrew name (if known)
3 Date of birth
/
MM
/
DD
YYYY
3 School and year attending
Your name
First
Last
Other parent's name
First
Last
Parent's Hebrew Names (if known)
Home Adress
Street Address
Address Line 2
City
Select a State
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State / Province / Region
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United States
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Your email
Other parent's email
Your mobile
Other parent's mobile
Home number
Synagogue members
Synagogue members
St. John's Wood / Saatchi
None
Other, name
Other, name
Parents are
Married
Divorced
Other
Does your child/ren take medication/ have allergies/ special needs? Any condition that we should be aware of?
Does your child/ren take medication/ have allergies/ special needs? Any condition that we should be aware of?
Yes
No
If yes, please specify
Has your child/ren attended Jewish school or other Cheder classes? please specify
How did you hear about us?
I understand that photos are taken and might be used for the weekly newsletters and community newsletters *
Yes
Are there any conversions in the family?
*
Yes
No
I will read the Covid-19 safety policy and adhere to it.
*
Yes
Draw your signature into the box below.
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