CTeen Junior Middle School Club Registration Form 2024/2025

CTeen Junior Middle School Club Registration Form 2024/2025
Parent Full Name*
First Name Last Name
Parent Phone Number*

Area Code Phone Number
Parent E-mail*
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Teen Full Name*
First Name Last Name
Teen Phone Number*

Area Code Phone Number
Teen Birth Date*

Month Day Year
Are there any conversions in the teen's family? *
If yes, please explain.
What school does your teen attend? *
Current Grade*
Membership Details:

CTeen Jr. Middle School membership is optional. Membership is recommended and includes free or discounted programs and events throughout the year. Non members will be able to join with a fee.

Pricing:

Chabad at Monterra Members: $200/per child.

Non Chabad at Monterra Members: $250/per child.

Per Program: $20
*This option is for those who wish to pay per program versus yearly!*
Would you like your teen to become a CTeen Middle School Member?* Optional
CTeen Donation? Chabad gladly offers the CTeen Jr. Middle School program open to all. Donations are greatly appreciated to help cover out CTeen expenses.

$
Total

$0.00

Payment*

Credit Card Paypal Zelle, Venmo

Postal / Zip Code

Country

Code of Conduct

By clicking the check box: Your teen understands that CTeen Jr. Middle School Club is a Jewish network for teens. Your teen will respect others, respect the building, follow instructions from the staff or Rabbi, and help CTeen Cooper City have the best year. It is the parent's responsibility to cover the costs of any damages caused by your teen.
Attestation of Non-Refundable Payment

I agree that at time of payment, there will be no refunds!
Should be Empty:

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