High Holiday Childcare 2024 - Form - Hebrew Institute of Riverdale

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* Parent's Last Name

* Parent's First Name

* Parent's Email

* Parent's Cell Phone

2nd Parent's Last Name

2nd Parent's First Name

2nd Parent's Email

2nd Parent's Cell Phone

* Which service are parents attending?

* How many children are you registering?

Please Select OneOneTwoThree

Please list all people besides parents who are authorized to pickup child.

* Child's Name

* Grade

Please let us know about any allergies or food sensitivities.

Which sessions are you registering your 3 year old for

Which sessions are you registering your Pre-K or Kindergarten child for

Which sessions are you registering your 1st - 4th grader for

2nd child's name

* Grade

allergies or food sensitivities

Which sessions are you registering your 3 year old for

Which sessions are you registering your Pre-K or Kindergarten child for

Which sessions are you registering your 1st - 4th grader for

3rd child's name

* Grade

allergies or food sensitivities

Which sessions are you registering your 3 year old for

Which sessions are you registering your Pre-K or Kindergarten child for

Which sessions are you registering your 1st - 4th grader for

Total Due: