DDD Melbourne Step Up Registration - Stand Up: Jewish Commitment to a Better World

First name

Last name

Email

Mobile

1. Child's full name:

2. Child's date of birth:

3. Child's gender:

4. The program you are enrolling your child in:

Term 3: 17 July - 4 September

5. Does your child have any allergies?

6. Does your child have any health issues we should know about?

7. Does your child have any dietary requirements?

8. What School is your Child Attending?

9. What is your child's Bar/Bat Mitzvah date?

10. I consent to photos of my child attending a Step Up Program to be taken and used for Stand Up's marketing purposes.