Information & Registration

Dates: September 24, October 22, November 8, November 19, December 22, January 21, February 28-March 2, March 25, April 29, May 9, May 20
Time: 7:00 pm (some times may vary)
Program Fee: $245 per year (includes all trips and programs excluding NY Trip and end year CTeen trip.) 
 
Teen INformation
First Name Last Name Mailing Address
City, State, Zip Cell
Home Phone Hebrew Name Date of Birth
School Attending Grade Best Contact
     
Parent's INformation
Father's Name Cell
Mother's Name Cell
Address City, State, Zip Home Phone
     
Payment Info
Expiration What's This?
 
$  
 

Permission is hereby given for Chabad of Badenton & Lakewood Ranch CTeen to use in promoting CTeen and in other ventures directly relating to CTeen/Chabad (i) digital, photographic, video, and audio images or likenesses of teen member; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by the teen member or originating from CTeen or from a CTeen related activity.

Initials: Date: