Printed from ChabadWesthempstead.org

Mini Chef Online Registration

Mini Chef Online Registration

 
ABOUT SCHEDULE PHOTOS REGISTER
 

Click here to download and print the registration form

First Name

Last Name
Age
School
Address
City/Zip
Phone Number
Parents Email Address
Mother Cell Number Father Cell Number
Emergency Contact #
Allergies (if any)
Hebrew Name
Birthday
Comments

The cost to enroll is $120.00 for the Mini Chefs program

Please choose one of the following payment plans

Payment in full $120

2 installments of $60 (with head checks)

I will pay by Check Credit Card

Name on card Credit card type
Card number
Security code
Expiration month Expiration year
Total amount to be charged Comments
Please check if you would like to sponsor another child for this club
 
A project of Chabad of West Hempstead
565 Nassau Blvd • West Hempstead, NY 11552 • 516-483-1683
Email:
chayarochel@yahoo.com

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