2026 RJW ECC Summer Open House & Family Shabbat Program
STUDENT INFORMATION
Child's First Name
Child's Last Name
Child's Date of Birth
Current School/Program (If none, write N/A)
PARENT/GUARDIAN INFORMATION
First Name
Last Name
Email Address
Phone Number
ACCOMMODATIONS
Do you need any accommodations to allow full participation in this event?
Yes
No
What accommodations do you need?
ALLERGIES
Does anyone attending have any allergies?
Yes
No
What are you allergic to?
Anything we should know to facilitate their safe and joyful participation?
How did you hear about this event?
Social Media
Friend
Website
Email
Mailer
Other
Please select all that apply
Please provide the person's name
If "other" please explain