Sign Up - BMDC 2023-2024 - ChabadWhitefield.com

Tell us a bit about yourself
Name of Bat Mitzvah girl*

First Name Last Name
Daughters full Hebrew name*
Date of birth*

Day Month Year
Rough time of birth*

Hour Minutes
Daughters mobile number

Area Code Phone Number
Parent's Information
Mothers name*

First Name Last Name
Mothers Hebrew name*

First Name Last Name
Mothers mobile number

Area Code Phone Number
Was your mother Jewish at birth?*
Maternal Grandmother's name
Maternal Grandmother's Hebrew name
Fathers Hebrew name

First Name Last Name
Are there any conversions or adoptions in the family? If so please specify*
If there is a conversion on the mothers side, please call Sora at 07940 313898 to discuss before submitting your form
Parent's email address*
I would like to receive news and updates by email
Home Information

Address*

Home phone number

Area Code Phone Number
Shul that family is member of
Other Information
High school attending*
Juniors school attended*
Name three friends* Please inform us who your daughter is close friends with.
*

I allow group photos of my daughter to be used on social media & in Jewish publication.
I would like to join a complimentary cooking class* Details will be given upon sign up for a Sunday that suits you

Yes, please email me more informationNo thank you
Please click here to send a photo of front & back of the Ketuba from mother of the Bat Mitzvah.

N:B if this is not available we can work this out through other channels.
Special circumstances
Tick all that apply to you. This will help the leaders reach out with more empathy.

Phobias/FearsTraumaBereavementsMedical history/dietary requirementMarital status of parents
Please inform us in what capacity the above apply to you, This will help the leaders reach out with more empathy.
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Sign Up - BMDC 2023-2024