2017 Summer Gesher Registration
This Summer Hebrew Program is offered at a flat, one time fee of $36. The $36 will cover your student's attendance for any number of sessions he/she wishes to attend. To make a secure credit card payment, please visit CRC's donation page at http://www.centralreform.org/donate and indicate it as an Education Fees Payment. If you would like to pay by check, please mail to CRC, with attention made to Addie Larson.
Student Name
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Student Birth Date
MM
/
DD
/
YYYY
Grade for 2017-2018 School Year
Student Allergies
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Parent 1 Name
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Parent 1 Email Address
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Parent 1 Phone Number
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Parent 2 Name
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Parent 2 Email Address
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Parent 2 Phone Number
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Emergency Contact Name
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Emergency Contact Phone Number
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Emergency Contact Relationship to Student
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Sessions
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