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CJP 2025-2026 Registration
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* Indicates required question
Child's Full Name:
*
Your answer
Child's Date of Birth:
*
MM
/
DD
/
YYYY
Child's Jewish/Hebrew Name:
*
Your answer
Home Address:
*
Your answer
Parent/Caregiver 1's Name:
*
Your answer
Parent/Caregiver 1's Phone Number:
*
Your answer
Parent/Caregiver 1's Email Address:
*
Your answer
Parent/Caregiver 2's Name:
Your answer
Parent/Caregiver 2's Phone Number:
Your answer
Parent/Caregiver 2's Email Address:
Your answer
Are you affiliated with a synagogue? If yes, which one?
Your answer
Is your child toilet trained?
Yes
No
Other:
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Does your child have allergies?
*
Yes
No
If you answered "Yes" to the previous question please list:
Your answer
CHOOSE A PROGRAM OPTION:
*
Toddler Program: At least 12 months old & walking
Transition Program: At least 2 years old by 8/1/2025
Preschool Program: At least 3 years old by 8/1/2025
Pre-Kindergarten Program: At least 4 years old by 8/1/2025
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