2020-2021 B'nai Mitzvah Registration

Please fill out the form completely. Make sure to hit the "submit" button at the end of the form.

You must be a current Kol HaLev member for your child to complete this final year of B'nai Mitzvah instruction.

* 7th grade/12-13 year olds

Members: First Child - $600Members: Two or more children - $850

If you would like to pay by check or make other arrangements for alternative payment methods, please contact KHL Treasurer, Laura Reames, 410-917-9147.

Total:

* Parent 1 Full Name

* Parent 1 Email Address

* Street Address (Primary)

* Zip Code

* Best Phone to Contact

* Parent 2 Full Name

Address for Parent 2 (if different than Parent 1)

Parent 2 Zip Code (if different than Parent 1)

Parent 2 Phone number

* (1) Child's First Name

* (1) Child's Last Name

* (1) Child's Birth date

(1) Child's Hebrew Name

* (1) Child's School

* (1) Child's Grade

Please let us know if your child has any allergies.

Allergies (Child 1)

Is there any information we should know about your child to optimize their experience during this last year of B'nai Mitzvah?

Notes for teachers:

(2) Child's First Name

(2) Child's Last Name

(2) Child's Birth date

(2) Child's Hebrew Name

(2) Child's School

(2) Child's Grade

Please let us know if your child has any allergies.

Allergies (Child 2)

Is there any information we should know about your child to optimize their experience during this last year of B'nai Mitzvah?

Notes for teachers:

* Emergency Contact:

Please provide the name, phone number and relationship to child.

* Photo Permission

Please Select OneYesNo

Permission to use photos of students in KHL publications -

No names will be posted.

Sat, January 16 2021 3 Shevat 5781