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Youth C-TEEN JR.

Register Your Child- KIK

Registration 2017 OPEN NOW!!!
First Name:*
Last Name:*
My Hebrew Name:*
My Birthday:*

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My School:*
My Grade*
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My Address:*

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Street Address Line 2
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My Phone Number*

- Area Code Phone Number
Father's name:*
Father's Phone Number*

- Area Code Phone Number
Mother's Name:
Mother's Phone Number

- Area Code Phone Number
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Amount

$125
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