Rosh Hashana & Yom Kippur Babysitting 2017

* Parent/Guardian 1 Name

Contact information is needed for at least one adult.

Email Address

* Cell Phone

Parent/Guardian 2 Name

Cell Phone

Home Address

How many children are you registering for?

MEMBERS

Child 1

How many days are needed? (Members)

Child 2

How many days are needed? (Members)

Child 3

How many days are needed? (Members)

NON MEMBERS

Child 1

How many days are needed? (Non-members)

Child 2

How many days are needed? (Non-members)

Child 3

How many days are needed? (Non-members)

Child name

Please complete one entry for each child

Age of Child please select one

Child name

Please complete one entry for each child

Age of Child please select one

Child name

Please complete one entry for each child

Age of Child please select one

Please select what services you will be attending

RH Day 1RH day 2YK

What Minyan is parent davening at

Any allergies or other notes

Total Fee

Must click "Submit Childcare Reservation" to complete registration.

Mon, June 23 2025 27 Sivan 5785

***** OUR EMERGENCY PHONE NUMBER IS (718) 327-0500 X7*****

728 Empire Avenue, Far Rockaway, NY 11691 ~ (718) 327-0500 ~ Fax: (718) 327-7415