Shavuoth Family Celebration

Parent/Guardian Information
Parent/Guardian Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Email*
Number of attendees:
Total Number of Children Attending:*
Total Number of Adults Attending:*
We will be attending in:*
- Highland Park
- Deerfield
Child Information
Child Name*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Does your child have any allergies?*
Child #2 Information
Child Name
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Does your child have any allergies?
Child #3 Information
Child Name
First Last
Date of Birth
Date Format: MM slash DD slash YYYY