Bar/Bat Mitzvah Registration Form 17-18
What is your child's name? *
Your answer
Bar/Bat Mitzvah Students Hebrew Name *
Your answer
Celebration Type *
What is your child's birthday on the Solar Calendar? Time of Birth is sometimes helpful since Hebrew Dates begin at sunset. *
MM
/
DD
/
YYYY
Time
:
What is the intended date of your celebration?
MM
/
DD
/
YYYY
Have you confirmed the booking with Rachael Lewinski? *
Cohen, Levi or Israel
Primary contact email *
Your answer
Mother's Name
Your answer
Mother's contact number *
Your answer
Mother's email *
Your answer
Father's name
Your answer
Father's contact info *
Your answer
Father's email *
Your answer
Bar/Bat Mitzvah Students Cell phone *
Your answer
Bar / Bat Mitzvah Student email
Your answer
Living Paternal Grandparents
Your answer
Living Maternal grandparents
Your answer
Deceased grandparents
Your answer
Siblings
Your answer
I would like to make a donation to help the synagogue support the bar/ bat mitzvah program activities and meals. *
Schara Tzedeck provides meals, resources and supplies to deliver a fun, exciting and welcoming program. We are asking for your assistance in supporting this educational programming.
Any additional information
Your answer
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