Bar Mitzvah Registration Form | Chabad Chai Center

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Family Information

Father's Full Name *

Father's Hebrew Name

Father's Cell # *

Father's Email *

Mother's First Name *

Mother's Last Name *

Mother's Hebrew Name

Mother's Cell # *

Mother's Email *

Street Address *

City *

Postal Code *

Siblings of Bar Mitzvah Boy

Please include ages

Is the Father Jewish? *

Yes No

Is the Mother Jewish? *

Yes No

Marital Status of Parents *

Married

Divorced

Separated

Any conversions in the family? *

Yes No

If yes, explain the conversions in the family

Any adoptions in the family? *

Yes No

If yes, explain the adoptions in the family

Bar Mitzvah Boy Information

Name of Bar Mitzvah Boy *

Hebrew Name

Current Hebrew School/Synagogue *

Birth Date *

Bar Mitzvah Date Preference *

Bar Mitzvah date will be reserved only after meeting with the Rabbi.

Comments

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Chabad Chai Center

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