Kesher 2019-2020 Registration

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Session dates: 9/22, 10/20, 11/17, 12/15, 1/19, 2/16, 3/29, 4/19, 5/3.
Please contact Joy Zotalis with any questions at 257-2944 or office@shamayim.org.

FAMILY INFORMATION

* New / Returning Family

* Parent/Guardian 1 First Name

* Parent/Guardian 1 Last Name

Home Phone

* Cell Phone

* Email

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Home Phone (if different)

Cell Phone

CHILD INFORMATION

* Child 1 First Name

* Child 1 Last Name

* Date of Birth

MM/DD/YYYY

Allergies or medical conditions

If no other children skip to the next section

Child 2 First Name

Child 2 Last Name

Date of Birth

MM/DD/YYYY

Allergies or medical conditions

PAYMENT INFORMATION

Member Rate: $36
Non-Member Rate: $54
$10 Material fee: For families bringing a second child who will participate in craft activities.

For scholarship information please contact Rabbi Laurie. Select 'pay by check' when registering.

MemberNon-MemberMaterials Fee (for those with a second child participating in craft activities)

Total

Upon hitting "Submit" you will be taken to a payment page where you can enter your credit/banking information to make a payment or select payment by check.

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