CKids Jewish Discovery Club

Ckids Information Details

Child's First Name *

Child's Last Name *

Child Jewish name

Example: David or דוד

Child's Date of Birth *

Birth Date Before Sunset (to calculate jewish birthday) *

Yes

No

Unknown

Grade entering fall 2024 *

Please list any allergies or necessary medical info *

Use this space to share anything you would like us to know about your child and what you would like your child to gain at JDC this year! *

Parent 1 name *

Parent 1 jewish name

Parent 1 Phone number *

Parent 1 Email *

Parent 2 name

Parent 2 jewish name

Parent 2 phone number

Parent 2 email

Emergency contact name & phone number *

Mailing address *

Are both parents jewish *

Are there any adoptions or conversions in the family? *

Yes No

If yes, explain

I allow my child to be photographed while participating in chabad activities and that these pictures may be used for marketing purposes.

Yes No