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Certificate of religious practice
Aleph Centre
Kerem
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Membership
Hall Hire
Safeguarding
BM ZONE
Bar Mitzvah Zone
Name of Participant
(Required)
First
Last
Date of Birth
(Required)
DD slash MM slash YYYY
School
(Required)
Please give any details of relevant medical conditions/allergies
(Required)
Parent/ Guardian 1
(Required)
First
Last
Email
Mobile Phone
Parent/ Guardian 2
First
Last
Email
Mobile Phone
Permission for details to be shared within the group
(Required)
Yes
No
Permission to be added to the Programme WhatsApp group
(Required)
Yes
No
Permission to have photographs taken during the sessions
(Required)
Yes
No
Do you give permission for your child to be included in photographs/videos for use in displays, publications and publicity in relation to this programme?
(Required)
Yes
No
HGSS Member
(Required)
Yes
No
Payment
Quantity
Price:
£ 75.00
Quantity
Total
Payment Method
PayPal Checkout
Credit Card
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name