Nitzanim and Mazel Tots! – Highland Park Conservative Temple

Child's Name *

First

Last

Child's Age *

Parent Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Please tell us for which program you would like to receive information; you will receive registration information prior to the program/session date *

Allergies – please check one *

ALLERGIES:

Please let us know how you learned about Nitzanim and Mazel Tots!

If other, please tell us how you learned about Nitzanim and Mazel Tots!