CTeen Contact List Form:)
Hi everyone! Welcome to Charlotte Cteen! As we're rolling into the start of the school year, CTeen is back on full swing! This form is for teens to fill out if they want to keep being informed about programs and events we will be having, whether that be virtually or in person! We can't wait for an AWESOME year!! :)
Email *
Teen Full Name/Nickname *
Jewish Name *
Teen Grade in year 21/22 *
School *
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Home Address *
Parent Info
Parent Names *
Parent Email *
Parent Phone Number *
Please list any allergy or dietary restrictions you have, or any other medical concerns that may affect participation at programs.
Any additional information we should know about you?
Please list any hobbies or interests you have!
Submit
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