Child's Name *

First Name

Last Name

Mother's Name *

First Name

Last Name

Father's Name *

First Name

Last Name

Child's Hebrew Name

First Name

Last Name

Mother's Hebrew Name

First Name

Last Name

Mother's Phone *

(###)

###

####

Father's Phone

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Monday Lunch *

Please select what you would like inside your bagel at lunch time! We will be eating lunch while out on our field trips. Lunch will include a bagel, fruit and vegetables, as well as snacks provided in the morning and afternoon.

Almond Butter

Sunflower Seed Butter

Tuna

Cream Cheese

Plain Bagel

Tuesday Lunch *

Almond Butter

Sunflower Seed Butter

Tuna

Cream Cheese

Plain Bagel

Wednesday Lunch *

Almond Butter

Sunflower Seed Butter

Tuna

Cream Cheese

Plain Bagel

Thursday Lunch *

Almond Butter

Sunflower Seed butter

Tuna

Cream Cheese

Plain Bagel