Teens Shul-in

6:00 PM - 2:00 PM Next Day

Adult Name

Adult Email

Adult Preferred Phone #

Teen Name

Allergies/Dietary Restrictions?

Any medications that will need to be taken during the Shul-In?

NOTE: Teens will be responsible for administering their own medication, we just want to be aware.

Teen Name

Allergies/Dietary Restrictions?

Any medications that will need to be taken during the Shul-In?

NOTE: Teens will be responsible for administering their own medication, we just want to be aware.

Teen Name

Allergies/Dietary Restrictions?

Any medications that will need to be taken during the Shul-In?

NOTE: Teens will be responsible for administering their own medication, we just want to be aware.

Anything else we should know?

Number of Teen Participants?

$36/Teen

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Sun, December 3 2023 20 Kislev 5784