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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