Bar/Bat Mitzvah registration Form

  • Bat Mitzvah Girl's Information

  • Parent 1 details

  • Parent 2 details

  • Emergency Information

  • Declaration of Parent or Guardian
    I hereby authorise Chabad Carnegie leaders and staff to obtain any medical care necessary for my child. I understand that in the case of emergency of any significant illness or injury, attempt will be made to contact myself when practical. I agree to pay for any cost that may occur as a result of the injury/illness. I acknowledge my child may be participate in activities within and outside the Chabad grounds. I authorise my child to participate in these activities. I hereby authorise Chabad Carnegie to photograph my child and to use the photographs at their discretion.

  • In order to  secure your place, a $100 non-refundable deposit is necessary. 

     I understand that the Application fee of $100 is the first installment of payment and and is on the basis of completing the full year program. I authorise Bar/Bat-Mitzvah club (Chabad Carnegie) to charge my credit card accordingly.  I also understand that the Application fee of $100 is non-refundable.

  • Credit Card
  • Should be Empty:
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