Full Name* First Name Last Name Gender:* MaleFemale E-mail* Allergies If this is your first time RSVPing for a CTeen Conejo event - Please visit www.chaiconejo.com/cteenwaiver to fill out the CTeen Conejo Permissions/Liability Waiver Waiver Form. This form only needs to be filled out once per participant. If you have filled this out already select "yes" below. I have signed and submitted the CTeen Conejo Permissions/ Liability Waiver Form:* Yes Enroll for Full Year? Yes, enroll for Full Year - $699No, I would like to sign up by session. I am also registering for a sibling Sibling Info: Sibling's Name First Name Last Name Gender: MaleFemale E-mail Allergies If this is your first time RSVPing for a CTeen Conejo event - Please visit www.chaiconejo.com/cteenwaiver (in a different window) to fill out the CTeen Conejo Permissions/Liability Waiver Form. This form only needs to be filled out once per participant. If you have filled this out already select "yes" below. I have signed and submitted the CTeen Conejo Permissions/ Liability Form: Yes Enroll for Full Year? Yes, enroll for Full Year - $699No, I would like to sign up by session: Girl's Schedule: Girls Session 1: Sept 14, 21, 28, Oct 5, 12 - $149Girls Session 2: Nov 9, 16, 30, Dec 7, 14 - $149Girls Session 3: Jan 11, 18, 25, Feb 8, 15 - $149Girls Session 4: Mar 1, 8, 15, 22 - $119Girls Session 5: Apr 19, 26, May 3, 10, 17 - $149 Total number of guests attending the Mother/Daughter Challah Bake on Sunday May 10 sisters and grandmothers also welcome! Boy's Schedule: Boys Session 1: Sept 11, 18, 25, Oct 9, 16 - $149Boys Session 2: Nov 6, 13, 20, Dec 4, 11, 18 - $149Boys Session 3: Jan 8, 15, 22, 29, Feb 5 - $149Boys Session 4: Feb 26, Mar 5, 12, 19, 26 - $119Boys Session 5: Apr 16, 23, 30, May 7, 14 - $149 I would like more info about: Monthly Volunteering on Sundays 12:30-2:30pm (8TH GRADERS ONLY)Bar Mitzvah Club Winter Session (BOYS AGES 12-13)Girls Bat Mitzvah Club Winter Session (GIRLS AGES 11-12) Parent's Info Parent's Name* First Name Last Name Phone Number* E-mail* Total $0.00 Payment Method* Credit CardCash/Check Payment Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Submit Clear Form Print Form Should be Empty: This page uses TLS encryption to keep your data secure.