B'nei Mitzvah Registration Form 
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Child Information
Child's First and Last Name *
Child's Hebrew Name
Is Your Child *
Child's Date of Birth: *
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Where does your child attend school? *
Does your child attend Talmud Torah at Beth El? *
Was your child born to a Jewish mother? *
If your child was not born to a Jewish mother, has the child converted?
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Is there any other information about your child you would like to share with us? (i.e. special needs, learning styles, etc.)
Parent Information
Parent 1 First and Last Name  *
Parent 1 Hebrew Name
Is Parent 1 *
Is Parent 1 Jewish according to the Conservative movement? (Born to a Jewish mother/converted) *
Parent 1 Home Address *
Parent 1 Phone Number *
Parent 2 First and Last Name *
Parent 2 Hebrew Name
Is Parent 2  *
Is Parent 2 Jewish according to the Conservative movement? (Born to a Jewish mother/converted) *
Parent 2 Home Address  *
Parent 2 Phone Number *
Is there any additional information about your family that you would like to share with us?
Please answer the following questions in regards to scheduling for your child's B'nei Mitzvah year. 

We are open to having our child’s B’nei Mitzvah without Rabbi Greyber present. 

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It is imperative for Rabbi Greyber to be present at our child’s B’nei Mitzvah. We are willing to be flexible with our date preference and understand that may include a multi-month delay from our preferred date. 

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B'nei Mitzvah Date Requests
Please keep in mind that holidays and/or other events may affect the schedule and availability of dates. 
1st Choice: *
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2nd Choice: *
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3rd Choice: *
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B'nei Mitzvah Covenant
Please "sign" (type) your name below to indicate that you have read and understand this commitment:

I/We would like our child to celebrate their B'nei Mitzvah at Beth El. I/We recognize that there is a mutual commitment between ourselves and the synagogue. I/We agree to the guidelines concerning attendance at synagogue, Talmud Torah and other B'nei Mitzvah related meetings and programs.
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Please share this with your child and have them "sign" (type) their name to indicate that they have read and understand this commitment:

I would like to celebrate my B'nei Mitzvah at Beth El. I understand that the synagogue will make a commitment to work with me and share in my celebration. In turn, I will be supportive of my community, especially my classmates, as we go through this process together. I commit to attending synagogue services, Talmud Torah classes and other B'nei Mitzvah related meeting and programs. I understand that there is a lot of work and preparation that goes into becoming a B'nei Mitzvah and I am prepared to take on this exciting challenge. 
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