Bat Mitzvah

Student Information
Full Name*
First Name Last Name
Hebrew Name*
First Name Last Name
Birth Date*

Day Month Year
School*
Year Level in 2026
Previous Jewish Education
Additional notable Information Please let us know if there are any allergies or other important information we need to be aware of.
Parents Information
Father's Name*
First Name Last Name
Father's Cell*

Phone Number
E-mail Father
Mother's Name*
First Name Last Name
Mother's Hebrew Name
Mother Jewish by:*

BirthConversionNot Jewish
Name of Rabbi who performed conversion
Mother's Cell*

Phone Number
E-mail Mother
I hereby authorise Chabad Dingley staff and/or volunteers to photograph my child and use the photographs for promotional purposesI hereby authorise a Chabad Dingley staff and/or volunteer to obtain any medical care necessary for my child, including from a medical practitioner, hospital or ambulance service. I understand that transportation to receive medical care may include an ambulance and I agree to pay for any costs involved with seeking medical care for my child. I understand that in the case of an emergency of significant illness or injury attempts will be made to contact myself or an authorised nominee, as soon as practical*
Payment
Fees*

Full Program $350Full Program plus Parsha Lessons for Boys $450
No child will be turned away due to lack of funds. Contact us if you need assistance.

Payment

Credit Card Bank Transfer

This page uses TLS encryption to keep your data secure.

Bar & Bat Mitzvah Club