Shalom Baby Registration
First Name *
Last Name *
Email *
Relationship to Baby
Baby's Name
Baby's Date of Birth or Due Date *
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DD
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Baby's Gender
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Baby's Mailing Address *
Parents Complete Names *
How did you hear about us? *
How do you identify your family? (Choose one)
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On a scale of 1 to 5, with 1 being least connected and 5 being most connected, how connected do you feel to your local Broward Jewish Community?
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Extremely connected
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