CTEENJR Registration

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Please complete this CTEEN JUNIOR registration form.

For your registration to save you must complete this form & the payment form.

The payment form has the option for payment plans and payment by check.

Child 1 First Name

Child 1 Last Name

Child 1 Hebrew Name

Child 1 Birth date

Child 1 School

Child 1 Grade Entering

Does The Child Live With Both Parents?

Any Medical Or Learning Conditions We Should Be Aware Of?

Child 1 Previous Jewish Education / Hebrew Reading Abilities

Child 2 First Name

Child 2 Last Name

Child 2 Hebrew Name

Child 2 Birth Date

Child 2 School

Child 2 Grade Entering

Child 2 Does The Child Live With Both Parents?

Child 2 Any Medical Or Learning Conditions We Should Be Aware of?

Child 2 Previous Jewish Education / Hebrew Reading Abilities

Parent 1 First Name

Parent 1 Last Name

Parent 1 Was

Adopted Born Jewish Converted Is Not Jewish

Parent 1 Cell Phone Number

Parent 2 First Name

Parent 2 Last Name

Parent 2 Was

Adopted Born Jewish Converted Is Not Jewish

Parent 2 Cell Phone Number

Consent

I hereby permit my child to be photographed and vidoed, and I allow Chaabd to use those photographs at their discretion. In case of any emergency I hereby authorize the staff of Chabad / Camp Gan Israel to take appropriate action, and absolve them, and any parent organization(s) of any liability., I allow the staff of Chabad / Camp Gan Israel to transport my child(ren)

CTEEN JUNIOR tuition cost for the year are $180 Supplies Fee.

Chabad serving LSU & Greater Baton Rouge

Chabadbatonrouge@gmail.com | 225-267-7047 | In everlasting memory of the founder of Chabad in Cyberspace, Rabbi Yosef Y. Kazen (father of Rabbi Peretz Kazen).