2021 Twelve & Thirteen Enrolment Form
If you have any questions about the program, please head to www.twelvethirteen.org/faqs. If you require assistance please contact us at hello@twelvethirteen.org.
Please indicate which stream you are enrolling in *
Full Name of Adolescent *
Please indicate your teen's gender. *
Full name of Parent/Guardian 1 *
Parent/Guardian 1 Email Address *
Parent/Guardian 1 Mobile phone number *
Please list any allergies your Young Adult has (or state none) *
Please list any medical conditions your young adult has (or state none) *
Do you give permission for us to use photographs of your young adult/family for marketing and social media purposes? *
Full name of Parent/Guardian 2
Parent/Guardian 2 Email Address
Parent/Guardian 2 Mobile phone number
Parent/Guardian 1 Residential Address *
Young Adult's School in 2021 *
Young Adult's Year Level in 2021 *
Young Adult's Date of Birth *
Young Adult's Phone Number
Required for Learning Labs and WhatsApp activations, can use Parent's
Young Adult's Email Address
Required for Learning Labs and WhatsApp activations, can use Parent's
Is your adolescent participating in any other Bar/Batmitzvah program? If yes, please list. *
How did you hear about Twelve & Thirteen? *
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