Registration for Chanukah Kulanu on Wednesday, December 13, 5:45-8:00 pm

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Email *

Name of person filling out this form on behalf of household. *

Phone Number *

How many people (𝗶𝗻𝗰𝗹𝘂𝗱𝗶𝗻𝗴 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳) in your household are attending? (Put # Here) *

Names of all people in your household who will be attending, 𝗶𝗻𝗰𝗹𝘂𝗱𝗶𝗻𝗴 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳. (Please put the ages of children in parenthesis). *

Please include any special dietary needs or allergies (vegetarian, vegan, pescatarian, gluten-free, etc.) of anyone in your household, if applicable. If not, please leave this section blank.

How did you hear about this program? *

BAS email

BAS website

Friend or family member

Facebook

Instagram

Meetup

Jewish Young(ish) Adults Email

Other:

In signing my name below, I grant Bet Am Shalom permission to use photos of my family members, including children (neither photos nor captions will contain any names) in synagogue publications, including but not limited to: slideshows used at BAS, Newsletters, Emails, Fliers, BAS Facebook and Instagram Pages, and the BAS website. If you do not agree, please note: Do not use my photographs. *

A copy of your responses will be emailed to the address that you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside Temple Bet Am Shalom. Report Abuse

Forms