Reigstraion Form

Children’s Programming and Babysitting Registration Form

(1 per family)

Parents or other responsible adult: _____________________Phone:________________

Other person authorized to pick up child(ren):___________________________________

PLEASE FILL OUT ALL INFORMATION

Babysitting - 1year old – 4 year old – payment required (see Registration and Payment form)

		Rosh Hashanah		Yom Kippur
		9-Sept	10-Sept	18-Sept
		9:45 am	9:45 am	9:45 am
Name	Age	1:15 pm	1:00 pm	1:15 pm




Please indicate a time each day (30 minute block if possible) when you can volunteer to assist in child care.

Minyan Katan – Pre-K through Grade 1 led by Sue Marx – no fee, parent must accompany children

Gesher Minyan - Grades 2-3 led by Sue Marx – no fee, parent must accompany children