Adventure rabbi

Adventure Rabbi Teens

Back to Adventure Rabbi Teens Page >>    

   

We have room for you!
Registration for Adventure Rabbi Teens:

Contract: This form will serve as a contractual agreement for enrollment in our Adventure Rabbi Teen Program, based in Boulder, Colorado.

Please include phone numbers where you can be reaching during the sessions.

Please provide the following:
Parent #1 Contact Information:
Parent #1 Name 
Parent #1 Email 
Parent #1 Phone 
Parent #2 Contact Information:
(If there is only one parent, leave this section blank)
Parent #2 Name 
Parent #2 Email 
Parent #2 Phone 
Student #1 Information:
Student #1 Name 
Select:  
Student #1 Birthday 
Student #1 Grade Entering 
Student #1 Allergies
/ Medical Conditions? 
Student #2 Information: (If you have two students in program)
Student #2 Name 
Select Class  
Student #2 Birthday 
Student #2 Grade Entering 
Student #2 Allergies
/ Medical Conditions? 
Additional Emergency Contact Information:
Contact 1 Name: 
Contact 1 Phone: 

Contact 2 Name: 
Contact 2 Phone:

Become A Member:

Become A Member!
Yes, please sign up my teen as a member for $236 per teen:

total
2 Teen Memberships - $472 total
1 Teen Membership for graduates of this year's B'nai Mitzvah Class - $141

More about Membership with Adventure Rabbi >>

Note: Must be a member for 2017 & 2018. Quickbooks will be set to
automatically charge your card on Jan 1, 2018 for membership.

Tuition Insurance:

 

 

 
Billing Information:
Name on Card 
Billing Address 
City 
State 
Zip 
Payment Method 
Card Number 
Exp. Date 
Code on Back of Card 
Comments: 
Terms,
Conditions
& Waiver: 

 <-- Please Enter your Initials to Agree
       to the Terms, Conditions and Waiver.

 

Free Jewish Calendar | Free Printable Mezzuah Scroll
Ask the Rabbi A Question | Have Adventure Rabbi Contact You Now

 Copyright (c) 2017, Adventure Rabbi, Inc. All Rights Reserved.

Adventure Rabbi is a 501(c)(3) non-profit Jewish organization, and is supported by donations and grants.
To make a tax-deductible donation, please click here >>
Or mail to:
Adventure Rabbi
5353 Manhattan Circle, Suite 103 Boulder CO 80303 (303) 417-6200
Adventure Rabbi Star Review of Adventure RabbiStar Review of Adventure RabbiStar Review of Adventure RabbiStar Review of Adventure RabbiStar Review of Adventure Rabbi 4.85 out of 5 based on 71 ratings. 18 user reviews.