Bat Mitzva Club Registration

Please fill out the form below carefully. When you press submit, this form (secure form) will be sent to our administration office.
|Student Information
Full Name*
First Name Last Name
Jewish Name*
Child's email (if applicable)

Address*

$100 Registration Fee Payment*

Credit Card

We accept Visa, MasterCard, American Express
Credit Card Number	Security Code
Expiration Month	Expiration Year

CVV*
Tuition Payment Options (for remaining $850 tuition)*

One time credit card payment in SeptemberCredit card payments in up to 5 installments - using the card I submitted above. (Please outline your preferred breakdown in the notes below.)Cheque (up to 5 post-dated payments.)
Please outline your preferred payment plan of up to 5 installments, paid in full by Jan 1, 2025. We will contact you to confirm.
I would like to assist a young girl who cannot afford Bat Mitzvah Club
|Consent
I/We hereby register my child in JRCC Bat Mitzvah Club.

Our club will be meeting Sundays throughout the year. See calendar for details.

I/We give my child permission to participate in all club activities and trips.

The student, as well as his parents or guardians, agree to abide by the rules and regulations set forth by the club.

Photos may be taken and used for future advertising.

I/We understand that JRCC does not assume responsibility for any injury, and in case of emergency necessary medical attention may be secured by the JRCC.

I/We confirm that all the details provided above are accurate, to the best of my knowledge, and if it becomes apparent that some of the provided information is inaccurate, it may be grounds to dismiss my child from the Bat Mitzvah Club

I/We understand that tuition will not reimburse to me/us, if I/we decide to pull out my child from JRCC Hebrew School at any time.
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