2024 Teen Mifgash

Parent Information

* Parent 1 First Name:

* Parent 1 Last Name:

* Parent 1 Email Address:

* Parent 1 Phone Number:

Parent 2 First Name:

Parent 2 Last Name:

Parent 2 Email Address:

Parent 2 Phone Number:

* Please list at least one emergency contact in case parents are not available at the time of event.

Name and Phone Number Please

* How many teens are you registering for?

Teen 1

* Teen 1, First Name

* Teen 1, Last Name

* Teen 1, Grade Level:

* Teen 1, Cell Phone (not a parents)

* Teen 1, Email (not a parents)

* Is Teen 1 participating going to Miami on Monday, March 25?

Cost: $30.00

* Is Teen 1 going to the Florida Panthers Game on Thursday, March 28?

Cost: $30.00

* For our overnight program Thursday, March 28 - Friday, March 29 Teen 1 plans to:

Cost: $30.00 for all options (unless not participating)

* Does Teen 1 have any food allergies?

Write n/a if nothing

* Is there anything else we need to know about Teen 1?

Write n/a if nothing

Teen 2

* Teen 2, First Name

* Teen 2, Last Name

* Teen 2, Grade Level:

* Teen 2, Cell Phone (not a parents)

* Teen 2, Email (not a parents)

* Teen 2 going to Miami on Monday, March 25?

Cost: $30.00

* Is Teen 2 going to the Florida Panthers Game on March 28?

Cost $30.00

* For our overnight program Thursday, March 28 - Friday, March 29 Teen 2 plans to:

Cost: $30.00 for all options (unless not participating)

* Does Teen 2 have any food allergies?

Write n/a if nothing

* Is there anything else we need to know about Teen 2?

Write n/a if nothing

Teen 3

* Teen 3, First Name

* Teen 3, Last Name

* Teen 3, Grade Level:

* Teen 3, Cell Phone (not a parents)

* Teen 3, Email (not a parents)

* Is Teen 3, going to Miami on Monday, March 25?

Cost: $30.00

* Is Teen 3, going to the Florida Panther Game on Thursday, March 28??

Cost: $30.00

* For our overnight program Thursday, March 28 - Friday, March 29 Teen 3 plans to:

Cost: $30.00 for all options (unless not participating)

* Does Teen 3 have any food allergies?

* Is there anything else we need to know about Teen 3?

Total Due:

Wed, May 8 2024
30 Nisan 5784

Shabbat Day

Parenthood Presents: ELC Parents Night Out in the Beck Family Campus Big Backyard

: 7:00pm

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May

Understanding Dementia: New Ideas for Prevention and Treatment with Dr. James Galvin
Thursday, May 9 7:00pm

May

Parenthood Presents: ELC Parents Night Out in the Beck Family Campus Big Backyard
Saturday, May 11 7:00pm

May

Brotherhood Mother's Day Brunch
Sunday, May 12 11:00am

May

Summer Solidarity Mission to Israel Informational Meeting
Wednesday, May 15 7:00pm

May

Deconfusing Israel Today
Thursday, May 16 7:00pm

Yom HaZikaron

Monday, May 13

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Wed, May 8 2024 30 Nisan 5784