Yehudi – Magen Avot Monthly Session 24

Name of Year 7 Participant(Required)

First Last

Participant Email(Required)

Secondary School(Required)

Name of Parent/Guardian(Required)

First Last

Parent/Guardian Email(Required)

Parent/Guardian Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code

Parent/Guardian Phone(Required)

Dietary Requirements

Please identify any dietary requirements e.g. vegetarian, vegan, nut allergy, gluten free, dairy free, pescatarian

Magen Avot Monthly Session

Total

Credit Card(Required)

Card Details

Cardholder Name

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