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Bat Mitzvah Club

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Registration and Dates

For more info or to set up private lessons, please contact Esther at (310) 721-1746
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New to Bat Mitzvah club!Returning for another awesome club!
Bat Mitzvah girls name:*
First Name Last Name
Hebrew Name:*
Phone Number:*
First Name Last Name
Birth Date:*

Month Day Year
Parent Information:
Full Name:*
First Name Last Name
E-mail:*
Phone Number:*

Area Code Phone Number

Address:*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Biological Mother:*
Choose One:*

Full year of Bat Mitzvah club: $250End of the year celebration: $36Pay by class: $25
Yes! I would like to help out & sponsor!

Bat Mitzvah Club: $2,500Full year for someone less fortunate: $250One class for someone less fortunate: $25
Total:

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment:

Credit Card

We accept Visa, MasterCard, American Express, Discover
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Expiration Month	Expiration Year

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