Chalutzim Fall 2025

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Parent/Guardian's Name

Email Address

Phone Number

Child's First Name

Child's Last Name

Child's Grade

Child's First Name

Child's Last Name

Child's Grade

Please select the dates your child(ren) will be attending

September 28 (12:15-1:45)October 26 (12:15-1:45) - see box below for additional info neededNovember 9 (12:15-1:45) see box below for additional info neededDecember 14 (12:15-1-45) see box below for additional info needed

October 26

#1 Grandparent Name

#2 Grandparent Name

November 9

I understand that a $10 donation is required per child check box(es)

#1 Child#2 Child

December 14

Please select all that apply

I am available to drive and transport other children.See box below.I am available to stay with the group at Solana

How many children can you transport including your own?

Will they be come directly from Religious School

Does your child have an allergies?

Any Questions or Concerns

Total amount due

Wed, September 17 2025 24 Elul 5785

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