Rabbi Isaac Simon Chidon Hamesorah Registration
Student Last Name *
Your answer
Student First Name *
Your answer
Grade *
father's email *
Your answer
mother's email *
Your answer
father's cell number
Your answer
mother's cell number *
Your answer
emergency contact name *
Your answer
emergency contact phone number *
Your answer
Alergies or medical conditions *
Your answer
Tell us something about the reason/goals you have in signing your child up for Chidon Hamesorah.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Harkham Hillel Hebrew Academy. Report Abuse - Terms of Service - Additional Terms