Registration

JEC/CTeen JR Registration 2026-2027
Child's Profile
Full Name*
First Name Last Name
Hebrew Name*
Birth Date*

Month Day Year
School*
Previous Jewish Education
Grade entering*

Address*

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

What are your goals in terms of your child's experience at Jewish Enrichment Club? Please number each line with numbers 1 to 5. (1=top priority), and add your own to the list. (0=not a priority) Thank you!
Jewish Identity Being in a Jewish environment Hebrew reading Hebrew Language Socializing with Jewish friends Jewish History Knowledge of holidays and traditions Knowledge of Jewish practices/mitzvot Knowledge of basic Jewish prayers
What are your goals for your child's experience at Jewish Enrichment Club?
Please number each line with numbers 1 to 5. (1=top priority) (0=not a priority) Please add your own goals that aren't listed, in the text box below.
Jewish Identity*
Being in a Jewish Environment*
Hebrew Reading*
Hebrew Language*
Socializing with Jewish friends*
Jewish History*
Knowledge of Holidays and Traditions*
Knowledge of Jewish Practices/Mitzvos*
Knowledge of basic Jewish Prayers*
Please add any of your priorities for your child at JEC that aren't listed above:
Additional notable information Please let us know if there are any allergies or other important information we need to be aware of.
CONFIDENTIAL: Does your child have an IEP or other learning challenges? If yes, please describe them and indicate special precautions or care needed.
Please Select Programs *

JEC (Grades K-5)CTeen JR (Grades 6-8)
Parents Information
Father's Name*
First Name Last Name
Father's Cell*

Area Code Phone Number
Father’s E-mail*
Mother's Name*
First Name Last Name
Mother's Hebrew Name
Mother's Cell*

Area Code Phone Number
Mother’s E-mail*
Marital Status*

MarriedSingleDivorced/Seperated
Is the birth mother and maternal grandmother of the child Jewish?*

YesNo
Have there been any conversions or adoptions in the family? If yes, please explain.
Would you like to volunteer at our youth programs?*

Yes!Not at this time
Thank you! What are some specific projects you’d like to help with? Ex: Setting up for lessons and events, leading a workshop, Aleph Bet reading with kids. Please specify how often you’d like to volunteer.
Payment
Registration Fee*

First Session- $400Second Sesison Session- $400Both Sessions- $750 (Save $50)
Total

$750.00

Payment

Credit Card Paypal Check/Cash

Postal / Zip Code

Country

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JEC/CTeen JR Registration 2026-2027

Child's Profile

What are your goals for your child's experience at Jewish Enrichment Club?

Parents Information

Payment

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