CTeen Membership Form
Thank you for taking the time to complete this application and becoming a member of CTeen of Newton.
Teen's Information:
First Name Last Name
Hebrew Name
Date of Birth
Home Address
Home Phone Cell
Email
School Grade
Best way to contact me is email phonetext facebook
Parent's Information:
Father's Name Cell
Mother's Name Cell
Email
Home phone
Home Address
Permission is hereby given for Beth Menachem Chabad of Newton CTeen to use in promoting CTeenand in other ventures directly relating to CTeen/Chabad (i) digital, photographic, video, and audio images or likenesses of teen member; and (ii) statements, articles, names, music, art, photographs, audio recordings, films and videos created by the teen member or originating from CTeen or from a CTeen related activity.
Comments:
