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Chabad Kids Club registration form

Chabad Kids Club registration form

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Chabad Kids Club Registration Form 

Family name *

        
 

Child #1 name * 
 

Child #1 birthdate *  
 

Child #1 grade *  
 

 

Child #2 name 
 

Child #2 birthdate   
 

Child #2 grade   
 

 

Child #3 name 
 

Child #3 birthdate   
 

Child #3 grade   
 

 

Child #4 name 
 

Child #4 birthdate   
 

Child #4 grade   
 

        


  

 

 

  Parents' Information:
 Names

 Father 
 

Mother 
 
 Address  
 City, State  
 Zip  
 Phone numbers  Father's cell #
 
Mother's cell #
  
 Email  Father's email
 
Mother's email
  


 

 Email