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CKids Hebrew School Registration

Parent's Information

Father's First Name *

Father's Last Name *

Gender

Father's Cell *

Father's Email *

Father's Jewish by *

Birth

Choice

Not Jewish

Mother's First Name *

Mother's Last Name *

Gender

Mother's Cell *

Mother's Email *

Mother's Jewish by *

Birth

Choice

Not Jewish

Street Address *

City *

Postal Code *

State/Province *

Best way to send Hebrew School updates *

Cell Phone

Email

Handout

Student Information

First Name *

Last Name *

Birth Date *

Month

Day

Year

Birth Before Sunset? *

Hebrew Name *

Previous Jewish Education

Current School *

Grade entering *

Additional Notable Information

Please let us know if there are any allergies or other important information we need to be aware of.

Participant Fee $

Add additional child?

Add additional child

Student 2 Information

First Name *

Last Name *

Birth Date *

Month

Day

Year

Birth Before Sunset? *

Hebrew Name *

Previous Jewish Education

Current School *

Grade entering *

Additional Notable Information

Please let us know if there are any allergies or other important information we need to be aware of.

Participant Fee $

Emergency Contact Information

Contact 1 Full Name *

Contact 1 Phone Number *

Contact 1 Relationship to Child *

Contact 2 Full Name *

Contact 2 Phone Number *

Contact 2 Relationship to Child *

info@cjcoxford.org | 203-514-0622

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