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Parent Information
Name:
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Cell:
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Please note that parent cell number will be added to a chat to communicate important trip information.
Email:
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School Information
Current School:
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Magen David
Flatbush
Hillel
Ramaz
Ilan
Barkai
Other (Please enter your school below)
Current Grade:
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8th Grade
9th Grade
11th Grade
School in September:
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Magen David
Flatbush
Hillel
Ramaz
Ilan
Barkai
Other (Please enter your school below)
Grade in September:
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9th Grade
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12th Grade / Captain
Summer Plans:
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Referral Information
Name:
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Phone Number:
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Email:
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Type:
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Referral cannot be a parent, sibling, or friend.
Other:
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