Hill Havurah Chizuk Program - 5780 (2019-20) - Form

Hill Havurah Chizuk Program - 5780 (2019-20)

Parent's Details

* First Name

* Last Name

* Email

Phone Number

First Name

Last Name

Phone Number

Child's Details

* Child's Name

* Grade

* School Attending

* On an ideal Shabbat, I...

Allergies and dietary restrictions

Special needs or accommodations

* Payment Submission

Total

Waiver

By submitting payment, you are agreeing to the waiver listed below:

All children enrolling in the Hill Havurah Chizuk Program 5780 and their parents or legal guardians waive all claims against Hill Havurah, the host, the teachers, the administrative staff, and volunteers for injury, accident, illness, or death occurring during or by reason of the program.

After hitting the submit button, you will be taken to a page where you can pay.

Thu, April 18 2024 10 Nisan 5784