Join Us


	Mommy & Me: 10:30-11:30am \| 5-24 months \| $75 \| 5 Tuesdays, July 21, 28 August 4, 18, 25
	Shabbat Little Kids Group: 10am-1pm \| 2-5 years \| FREE \| Every Saturday Morning

	Child's Name:
	Date of Birth: Sex: Boy: Girl
	Mother's Name:
	Father's Name:
	Address:
	City: State: Zip Code:
	Home Phone: Mother's Cell: Father's Cell
	E-mail Adress
	Emergency Contact's Name: Phone:
	Emergency Contact's Name: Phone:
	Allergies:
	Session: Fall 2008 (class schedule will be updated July 1, 2008)
	Religion: Jewish Other
	Religious Affiliation: Orthodox Conservative Reform Traditional
	Synagogue Affiliation: School Affiliation:
	What do you hope to gain from this program:
	Where did you here about us?