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Bat Mitzvah Club

Bat Mitzvah Club

Girls | Ages 11-13

Bat Mitzvah Club

Get to know your Jewish Self through Hot Topic discussions ~ Funky Art ~ Exciting Projects
Share your interests, goals & dreams. Give yourself the gifts of Self Confidence, Jewish Pride & Lasting Friendship

For Girls ages 11-13 
Led by Mrs. Rochie Perelmuter

At The JCC
3801 E. Willow St. Long Beach 90815

Once A month on Sundays from 11:30-12:30

October 29nd, November 19th, Dec 17th, Jan 28th, Feb 25th, March 25th, April 22nd

For more information please call 562 621 9828 or email Rochie@shulbytheshore.org

 

Bat Mitzvah Girl Information
Last Name
First Name
Hebrew Name
Civil Date of Birth
Time of Birth
Jewish Birthday if known
Is the Bat Mitzvah Girl Jewish by Birth?
Yes No
Is the Bat Mitzvah Girl Adopted?
Yes No
Is the Bat Mitzvah Girl converted?
Yes No
School Attending
Grade
Home Phone
Cell Phone
Email
Facebook
Parent Information
Marital Status
   
Address
City
Prov/State/Postal Code

Father

Title/First Name
Last Name
Jewish Name
Work Phone
Cell Phone
Email
Mother
Title/First Name
Last Name
Jewish Name
Maiden Name
Is mother Jewish by Birth?
Yes No
*If No please provide documentation 
Mother's Mother's Jewish Name
Work Phone
Cell Phone
Email
Fees & Payment Information
Fee: $120 for full year membership • Please Choose Payment Method  
Card Number
Name on Card
Expiration Date
Security Code
Billing Address
Billing Postal
Disclaimer
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Shul by the Shore Bat Mitzvah Club to hospitalize or secure treatment for my/our child, I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Shul by the Shore Bat Mitzvah Club personnel will try, but are not required, to communicate with me/us prior to such treatment. I/we hereby give permission for my/our child to participate in all club activities, join in trips on and beyond club properties and allow my/our child to be photographed while participating in Bat Mitzvah Club activities. I/we also understand that all liability and costs resulting from damage to property and/or personal injury caused or attributable to my/our child/children will be my/our responsibility and I/we agree to fully indemnify and save Shul by the Shore Bat Mitzvah Club and it’s associates, teachers and agents harmless therefrom. I/we consent to Shul by the Shore Bat Mitzvah Club's use of our personal information and of our child/children at its discretion in pursuit of club activities. There are no refunds or credits for days missed due to illness, holidays, or family vacations.
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