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Register - Jewish Kids Club

Name *
Name
Birth Date *
Birth Date
Emergency Information
Full Name
Full Name
Phone Number *
Phone Number
Is your Child taking permanent medications? *
Any known allergies or present medical conditions? *
Phone Number *
Phone Number
Address *
Address
Tuition and Billing
Tuition Hebrew School Primary Program (Grades Pre-K through 7th): $120 per 6 week session
Payment *