CKids Shabbaton Child - 5780

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CKids Shabbaton - Child Registration

Which Ckids group are you in?*

How many children are registering on this form?*

Child 1

Name*

First Name*

Last Name*

Hebrew Name *

First Name*

Last Name*

Adress*

Address Line 1

City

State/Province

ZIP / Postal

Country

Gender*

Male Female

Grade of JewQ content learnt?*

3rd grade 4th grade 5th grade 6th grade 7th grade

Other: Other Value

What is your average JewQ test score?

If you do not know your average, please submit the form and email shabbaton@ckids.net

Age*

Sweatshirt Size*

Youth S Youth M Youth L Youth XL Adult S Adult M Adult L

Any allergies? (Please include allergy, and any symptoms we should be aware of)

Any other medical info or special needs? please add Medications (Include medication name, dosage, schedule).

Parent email*

Parent phone*

Please fill out the waiver and upload it here. Copy this link into your browser to get the waiver: https://bit.ly/2SYksmz

Waiver

No File Chosen

File uploads may not work on some mobile devices.

JewQ Champion Photo - please upload your child's photo here

JewQ Champion Photo - (please upload your child photo here)

No File Chosen

File uploads may not work on some mobile devices.

Address where you will be staying in crown heights? (Your Chabad Rabbi/Rebbetzin will assist you in finding a host, you will also eat the shabbos day meal at your host or other location of your choice) (If you don't have this info yet, send it to us later)

Address Line 1

Address Line 2

City

State

ZIP Code

Child 2

Name*

First Name*

Last Name*

Gender*

Male Female

Grade of JewQ content learnt?*

3rd grade 4th grade 5th grade 6th grade 7th grade

Other: Other Value

What is your average JewQ test score?

If you do not know your average, please submit the form and email shabbaton@ckids.net

Age*

Sweatshirt Size*

Youth S Youth M Youth L Youth XL Adult S Adult M Adult L

Any allergies? (Please include allergy, and any symptoms we should be aware of)

Any other medical info or special needs? please add Medications (Include medication name, dosage, schedule).

Parent email*

If different from Child 1

Parent phone*

If different from Child 1

Please fill out the waiver and upload it here. Copy this link into your browser to get the waiver: https://bit.ly/2SYksmz

No File Chosen

File uploads may not work on some mobile devices.

JewQ Champion Photo - please upload your child's photo here

No File Chosen

File uploads may not work on some mobile devices.

Address where you will be staying in crown heights? (you need to find your own host, you will also eat the shabbos day meal at your host or other location of your choice) (If you don't have this info yet, send it to us later)

Address Line 1

Address Line 2

City

State

ZIP Code

Child 3

Name*

First Name*

Last Name*

Gender*

Male Female

Grade of JewQ content learnt?*

3rd grade 4th grade 5th grade 6th grade 7th grade

Other: Other Value

What is your average JewQ test score?

If you do not know your average, please submit the form and email shabbaton@ckids.net

Age*

Sweatshirt Size*

Youth S Youth M Youth L Youth XL Adult S Adult M Adult L

Any allergies? (Please include allergy, and any symptoms we should be aware of)

Any other medical info or special needs? please add Medications (Include medication name, dosage, schedule).

Parent email*

If different from Child 1

Parent phone*

If different from Child 1

Please fill out the waiver and upload it here. Copy this link into your browser to get the waiver: https://bit.ly/2SYksmz

No File Chosen

File uploads may not work on some mobile devices.

JewQ Champion Photo - please upload your child's photo here

No File Chosen

File uploads may not work on some mobile devices.

Address Line 1

Address Line 2

City

State

ZIP Code

Billing

Total* $

Discount Code

Credit Card*

Credit Card