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Parent's Name* First Name Last Name E-mail* Phone Number* Select program:* Preschool Age ChildrenElementary Age ChildrenTeens Family Program for Preschool Age Childrenwith Devorah Deitsch No. of children attending:* (1) Child's Name:* First Name Last Name (1) Child's Age:* (1) Rosh Hashanah: Family Program: 10:30-11:00 AMBabysitting (ages 2-5): 11:00 AM - 12:30 PM (1) Yom Kippur: Family Program: 10:30-11:00 AM (2) Child's Name:* First Name Last Name (2) Child's Age:* (2) Rosh Hashanah: Family Program: 10:30-11:00 AMBabysitting (ages 2-5): 11:00 AM - 12:30 PM (2) Yom Kippur: Family Program: 10:30-11:00 AM (3) Child's Name:* First Name Last Name (3) Child's Age:* (3) Rosh Hashanah: Family Program: 10:30-11:00 AMBabysitting (ages 2-5): 11:00 AM - 12:30 PM (3) Yom Kippur: Family Program: 10:30-11:00 AM (4) Child's Name:* First Name Last Name (4) Child's Age:* (4) Rosh Hashanah: Family Program: 10:30-11:00 AMBabysitting (ages 2-5): 11:00 AM - 12:30 PM (4) Yom Kippur: Family Program: 10:30-11:00 AM (5) Child's Name:* First Name Last Name (5) Child's Age:* (5) Rosh Hashanah: Family Program: 10:30-11:00 AMBabysitting (ages 2-5): 11:00 AM - 12:30 PM (5) Yom Kippur: Family Program: 10:30-11:00 AM Family Program for Elementary Age Childrenwith Rabbi Sholom and Liba Loebenstein No. of children attending:* (1) Child's Name:* First Name Last Name (1) Child's Age:* (1) Rosh Hashanah: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (1) Yom Kippur: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (1) Mincha & Neila: Supervised Play: 6:00 - 7:00 PM (2) Child's Name:* First Name Last Name (2) Child's Age:* (2) Rosh Hashanah: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (2) Yom Kippur: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (2) Mincha & Neila: Supervised Play: 6:00 - 7:00 PM (3) Child's Name:* First Name Last Name (3) Child's Age:* (3) Rosh Hashanah: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (3) Yom Kippur: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (3) Mincha & Neila: Supervised Play: 6:00 - 7:00 PM (4) Child's Name:* First Name Last Name (4) Child's Age:* (4) Rosh Hashanah: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (4) Yom Kippur: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (4) Mincha & Neila: Supervised Play: 6:00 - 7:00 PM (5) Child's Name:* First Name Last Name (5) Child's Age:* (5) Rosh Hashanah: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (5) Yom Kippur: Family Program: 10:30-11:00 AMHigh Holiday Kids Club: 11:00 AMSupervised Play: 12:00 - 1:00 PM (5) Mincha & Neila: Supervised Play: 6:00 - 7:00 PM Teens ProgramRound Table Discussion with Rabbi Sholom: 11:10 - 11:45 AM No. of teens attending:* (1) Child's Name:* First Name Last Name (2) Child's Name:* First Name Last Name (3) Child's Name:* First Name Last Name (4) Child's Name:* First Name Last Name (5) Child's Name:* First Name Last Name I would like to donate... $54$72$108 Total $0.00 Payment Credit Card Paypal Cash / Mail-in Check Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPaypal has been selected. 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