2024 HH Youth Registration Form

Registration form is due September 20.

Please note: If your child is in Childcare or participating in Youth Programming, you are required to remain on the Har Shalom campus.

* First Name

* Last Name

* Email Address

* Phone #

* Address

Apt/Unit # (if applicable)

* City

* State

* Zip

Childcare & Youth Programming Registration

Childcare and youth programming is complimentary for Har Shalom members.

Non-member charges for childcare are:

$18/child per service for Erev Rosh Hashanah and Rosh Hashanah Day 1
$18/child per service for Kol Nidre and Yom Kippur

* Are you members of Har Shalom?

Rosh Hashanah

Total number of children attending Erev Rosh Hashanah Service

Total number of children attending Rosh Hashanah Day 1 Programming or Childcare

Ages of Children

Ages 1 through 3

Pre-K through Grade 3

Grade 4 - 7

Yom Kippur

Total number of children attending Kol Nidre Service

Total number of children attending Yom Kippur Service

Ages of Children

Ages 1 through 3

Grades Pre-K through 3

Grade 4 - 7

Would you like to make a donation to support additional High Holiday programming? If so, please enter the amount below.

Total Due

Sun, September 15 2024 12 Elul 5784