New Family Registration - Chabad of West Hempstead

Address*

Family Information
Child 1
Full Name
First NameLast Name
Birthday
MonthDayYear
Age
School
Grade
Child 2
Full Name
First NameLast Name
Birthday
MonthDayYear
Age
School
Grade
Child 3
Full Name
First NameLast Name
Birthday
MonthDayYear
Age
School
Grade
Child 4
Full Name
First NameLast Name
Birthday
MonthDayYear
Age
School
Grade
Please list information for additional children below.
Conclusion
Please describe when you'd be interested in volunteers (days, times, etc,)
Please list any allergies we should know about.
Questions/Comments
If you have any questions, please feel free to contact the Friendship Circle Office at [email protected], or Chaya Rochel at [email protected]
We can't wait to see you!
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Friendship Circle Registration for Families