Childcare Registration and Payment Form

High Holy Days Childcare 2022

Parent Contact Name(Required)

First Last

Parent Contact Email(Required)

Parent Contact Phone(Required)

Guest or Visitor to B'nai Israel

If you are a guest or visiting from out of town, please share the name of your contact or relative at B'nai Israel.

Please Note: Children must be between the ages of 3 months and 5 years old.

How many children are you registering?

One Child

Two Children

Three or More Children

List Child or Children's Names

Please submit one name per line. The plus sign at the end of the box will create a new line.

Tell us about your child/children

Please let us know about allergies, special dietary needs, etc,.

Rosh Hashanah Morning 9/26/2022

Quantity must be the same as the number of children you are registering or your registration will not be guaranteed.

Price: $36.00

Yom Kippur "MORNING" 10/5/22

Quantity must be the same as the number of children you are registering or your registration will not be guaranteed.

Price: $36.00

Yom Kippur "AFTERNOON" 10/5/2022

Price: $36.00

Quantity must be the same as the number of children you are registering or your registration will not be guaranteed.

Subtotal

Credit Card Fee

Price: $0.00

Total Due

Opt Out

I chose not to pay the 2% credit card fee.