High Holy Days: Childcare & Kids Club - Form

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Childcare & Kids Club

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip

Home Phone

Mobile Phone

6 Months - 1 Year $30

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

2-3 Years $25

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

4 Years - Pre-Kindergarten $20

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Kids Club (Grades K-3) No Charge

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Grades 4 & 5 Special Program No Charge

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies

Child Name

Child Age

Child Grade (if applicable)

Session - Mark All That Apply

Rosh Hashanah Aleph Service Yom Kippur Alef Service

Allergies