Yom Kippur Youth Experience 2021 - Form - Kehal Kodesh Bene Israel Rockdale Temple

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(513) 891 9900
8501 Ridge Road
Cincinnati, OH 45236
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Yom Kippur Youth Experience 2021

* What is your child's name?

* Age

* Grade

* I am registering my child for

Would you like to register another child?

* What is the name of your second child?

Age

* Grade

I am registering my child for

* Would you like to register another child?

What is the name of your third child?

What is their age?

Grade

I am registering my child for

Would you like to register another child?

What is the name of your third child?

What is their age?

Grade

I am registering my child for

Does your child(ren) have any allergies, special dietary needs, or health issues?

* Parent/Guardian Name:

* Parent/Guardian Cell Number

* Email:

Parent/Guardian Name 2:

Parent/Guardian 2 Cell Number:

Emergency Contact Name:

Non-parent, non-participant

Emergency Contact Phone Number:

Mon, October 13 2025
21 Tishrei 5786

Mon, October 13 2025 21 Tishrei 5786

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