Bat Mitzvah Club Registration - Chabad Lubavitch of Sunny Isles Beach

We are currently accepting application forms for the 2026-2027 Bat Mitzvah Club. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please email [email protected] or call (305) 792-4770

Student's Name*

First Name Last Name

Hebrew Name*

Birth Date*

Month Day Year

Was your daughter born after nightfall?

YesNo

What school does your daughter attend?

Grade Entering

Synagogue Affiliated with

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Any conversions or adoptions in the family? If yes, please explain*

Is the child's mother Jewish?*

By BirthNot JewishBy Choice

Is the child's maternal grandmother Jewish?

By BirthNot JewishBy Choice

Please attach any relevant documents such as proof of conversion, ketuba etc

Father's Full Name*

First Name Last Name

Father's Phone Number*

Father's E-mail

Mother's Full Name*

First Name Last Name

Mother's Hebrew Name*

First Name Last Name

Mother's Phone Number*

Mother's E-mail

Emergency Contact

First Name Last Name

Relationship to child

Phone Number

Emergency Contact 2

First Name Last Name

Relationship to child

Phone Number

Who referred you to Bat Mitzvah Club?

Does your daughter have any allergies, other medical conditions or special needs we should be aware of?

YesNo

If yes, please describe them and indicate special precautions or care needed.

As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Bat Mitzvah Club to hospitalize or secure treatment for my/our child, I/we further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Bat Mitzvah Club personnel will try, but are not required, to communicate with me/us prior to such treatment. I/we hereby give permission for my/our child to participate in all school activities, join in class and school trips on and beyond school properties and allow my/our child to be photographed while participating in Bat Mitzvah Club activities. I/we also understand that all liability and costs resulting from damage to property and/or personal injury caused or attributable to my/our child/children will be my/our responsibility and I/we agree to fully indemnify and save Bat Mitzvah Club and it’s associates, teachers and agents harmless therefrom. I/we consent to Sunny Isles Bat Mitzvah club use of our personal information and of our child/children at its discretion in pursuit of school activities.

Initials & Date

The total program cost is $750, which includes a $150 non-refundable registration fee and a $600 tuition fee, both due in full at the time of registration to secure your spot for the designated Wednesday sessions from 5:00-6:30pm at 17555 Atlantic Boulevard CU1, Sunny Isles Beach, FL 33160. If you opt for the 3-payment plan, your card will be automatically charged $200 on September 1, October 1, and November 1, with a 3% processing fee applied to each of these three charges.

Promo Code:

Registration Fee*

$150

Payment Options*

Pay in full3 payments

Total

$0.00

Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

There are no refunds or credits for days missed due to illness, holidays, or family vacations.

Bat Mitzvah Club Registration 2026-27