בס"ד

Kids in the Kosher Kitchen
REGISTRATION
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Family Name:
Mother's Name:
Father's Name:
Child's Name:
Date of Birth:
E-mail:
Sessions attending:
Full Progran Nov. 22nd Jan. 10th
Feb. 14th March 20th April 10th
May 15th June 5th

Total Amount:

Payment Method:
Name on Credit Card:
Credit Card Number:
Code:
Expiry Date:
Please list any food allergies: