Bnei Mitzvah Program - Beit Rayim Synagogue

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B'nei Mitzvah Program 2022 / 2023

Program Options
Thursdays Only = $700
Note: This option includes all program enrichments, social and youth events offered from September - May

Thursdays and Sundays = $1700
Note: This option includes all program enrichments, social and youth events offered from September - May

To enroll in the program, please fill in the form below

Registration Form

B'nai Mitzvah Program Registration

Welcome to our B'nai Mitzvah Community. Please fill in the form below to complete registration for the 2022 / 2023 B'nai Mitzvah Program.

Please note: For booking, tutoring information, and any other service details please contact Robyn at the Beit Rayim Synogogue Office

* Parent / Guardian 1 Full English Name

Parent / Guardian 2 Full English Name

* Parent / Guardian 1 Full Hebrew Name

If you are unsure how to write your Hebrew name with Hebrew characters, write with transliteration using English characters.

* Parent / Guardian 2 Full Hebrew Name

If you are unsure how to write your Hebrew name with Hebrew characters, write with transliteration using English characters.

* Phone Number

* Email Address

* B'nei Mitzvah Student's Hebrew Name

If you are unsure how to write your Hebrew name with Hebrew characters, write with transliteration using English characters.

* I am Jewish

* Are your family members of Beit Rayim Synagogue?

* Is the Bar/Bat Mitzvah scheduled at Beit Rayim Synagogue?

* First Name of B'nei Mitzvah Student

* Last Name of B'nei Mitzvah Student

* B'nei Mitzvah Student's Hebrew Name

If you are unsure how to write your Hebrew name with Hebrew characters, write with transliteration using English characters.

* B'nei Mitzvah's Birthday

* Bar/Bat Mitzvah Date

* B'nei Mitzvah's Gender

* Choose an Option:

Thursdays and SundaysThursdays OnlyPlease note: any member discounts will be applied directly to your Beit Rayim account

* Child Participation Consent Form

Child Participation Consent FormBR and its representatives take great effort and precautions to assure the safety and welfare of your child. In the event of a health-related incident we will contact you immediately at the phone numbers you provide below. The undersigned understands, agrees, represents and warrants to BR that: 1. I am the parent or legal guardian of the child/children listed below. 2. BR, its directors, officers, employees and volunteers shall not be responsible for any and all claims for damages arising as a result of any accident, injury or otherwise sustained by the child/children arising from participation in any BR activities. 3. I permit my child/children to participate in each BR activity(s) that she/he/ they attend(s). 4. BR officials may act on my behalf in case of emergency. 5. Any special medical issues, allergies, special needs or other concerns that BR ought to be aware of are listed in the above registration form. By checking this box you confirm that you, as a parent/guardian of the child(ren), have read and agree to the terms and conditions above.

* I have read and accept the COVID-19 Assumption of Risk, Waiver and Conduct

I have read and accept the COVID-19 Assumption of Risk, Waiver and ConductClick here to view our COVID-19 ASSUMPTION OF RISK, WAIVER AND CONDUCT document.

* Photo Consent

Photo ConsentBeit Rayim Synagogue and School may take photographs or videotapes for use in promotional materials. We do not post names with the pictures. Please indicate if you agree to this for your child(ren) by checking the box below. By checking yes, you give your consent for photographs or videotape of you and/or children child(ren) to be used by Beit Rayim Synagogue and School for promotional purposes. By selecting No,you do NOT give consent for photographs or videotape of you and/or your child(ren) to be used by Beit Rayim Synagogue and School for promotional purposes.

* Does the B'nei Mitzvah have any allergies or medical concerns we should be aware of?

YesNoIf yes, please provide details below of your child's allergies or medical conditions that require our attention.

Total Cost:

Please note: any member discounts will be applied directly to your Beit Rayim account

* We will be sending out multiple emails with regards to program updates, upcoming events, and so on. Which email would you like us to send this information to?