C-Teen Jr. Sign Up

Address*

Teen Info:
Full Name:*

First Name Last Name
Cell Phone:*

Area Code Phone Number
Birth Date:*

Month Day Year
School Currently Attending:*
Grade Currently Attending:*
Registration:

C-Teen Jr. at Chabad of Greater Orlando does not have a registration fee, however each event will have a small fee to cover costs. This form will be updated with each months events if you would like to select specific events to come to.
I would like to join:*

The whole year!: $360 Top Golf 4/3 (Lake Mary) I have a pass: $12 Top Golf 4/3 (Lake Mary) I don't have a pass: $17
Please help out!

I would like to sponsor a Teen for a Year - $360 OMG!! $250 Would love to partner with Cteen Jr.: $100 Let's do it: $50
Total:

$0.00

Payment:

Credit Card

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Street Address

Street Address Line 2

City

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Postal / Zip Code

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