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CKids Mitzvah March Madness

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Full Name (of parent or guardian)*
First Name Last Name
E-mail*
Phone Number*
Full Name Of Child*
First Name Last Name
Grade:*
Age:*
Previous Jewish Education:
Is The Biological Mother Of The Child Jewish?*

YesNo
Were There Any Conversions In The Family?*

YesNo
If You Answered Yes To The Previous Question Please Elaborate:
Payment:
$35 For All Three Lessons - $15 For A Single Lesson*

$15$35
Total

$15.00

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