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Kids Torah Class Registration

Student Information
Full Name*
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date*

Month Day Year
School*
Grade entering*
2nd Student Information
Full Name
First Name Last Name
Hebrew Name
First Name Last Name
Birth Date

Month Day Year
School
Grade entering

Address*

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

Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Payment
Cost per year: $600
How many kids are you registering?
Total

$0.00

Payment

Credit Card Check or Zelle

Postal / Zip Code

Country

Should be Empty:

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