Registration - Chabad Jewish Community Center

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CKids Folsom & El Dorado Hills

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Registration

This form is currently closed.

Ckids Club Registration
Hebrew School student?

YesNo
Number of Kids
Child Name*
First Name Last Name
Birth Date*

Month Day Year
Child Name*
First Name Last Name
Birth Date*

Month Day Year
Child Name*
First Name Last Name
Birth Date*

Month Day Year
E-mail*
Phone Number*

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Event fee for one child*

$15
Event fee for 2 children*

$30
Event fee for 3 children*

$45
I would like to add a donation.

$54 - Bronze Sponsor$180 - Silver Sponsor$360 - Gold Sponsor
Total

$90.00

Payment

Credit Card Paypal

Postal / Zip Code

Country

I would like to receive news and updates by email
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