טופס הרשמה למועדון 'לגדול' - סמסטר השני, תשפ"בFull Name of Parent*First NameLast NameE-mail*I would like to receive news and updates by emailPhone Number*Area CodePhone Numberתאריך לידה של הילד*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Yearתאריך לידה עברי (באם ידוע)Grade:Please selectPreschoolGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Full Name of Child:*First NameLast Nameשם עברי:First NameLast NameNumber of Children:*Full Name of 2nd Child:First NameLast Nameשם עברי:First NameLast NameBirth Date (2nd Child):1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGrade (2nd Child):Please selectPreschoolGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Full Name of 3rd Child:First NameLast Nameשם עברי:First NameLast NameBirth Date (3rd Child):1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearGrade (3rd Child):Please selectPreschoolGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6רמת עברית של הילד/ה/ים:*Total:$0.00Payment*Credit Card Paypal Credit CardVisaMasterCardAmerican ExpressCredit Card TypeCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2022202320242025202620272028202920302031Expiration YearPaypal has been selected. Payment will take place on the next page.המועדון יתקיים בחב"ד מידי יום ראשון בין השעות 10:30 - 12:30. לוח תאריכי המפגשים יישלח לנרשמים !מחכים לראות אתכםSubmitShould be Empty: This page uses TLS encryption to keep your data secure.