Cteen Annual Registration
School Year 2022-23
Membership entitles CTeens to to join monthly meetings and events at a reduced rate, and comes with other member benefits, like leadership roles, and CTeen apparel.
Annual Fee: $180.
Monthly Events will require a nominal fee for the cost of that event.
| Gender | |||
| School | |||
| Address | Grade | ||
| City, Zip & State | Hebrew Birthday | ||
| Teen's Cell | Synagogue | ||
| Teen's Email | Biological Mother | ||
| Emergency Contact | Emergency Contact Phone | ||
| Mother's Name | Father's Name | ||
| Mother's Phone | Father's Phone | ||
| Mother's Email | Father's Email |
| Payment Method | Card Number | ||
| Expiration | CVV Code | ||
| Cardholder's Name | Billing Zip | ||
| Total Amount ($180) | Comments | ||
| Check can be mailed to Chabad of South Orlando • 7347 W Sand Lake Road • Orlando, FL 32819 | |||