Bar Mitzvah Club Registration Form

 First Name
 Hebrew Name
 Last Name

 State      Zip Code

 Home Phone
 Email Address


 Hebrew Birthday


Parents information  

 Mother's Name
 Mother's Cell Number

 Father's Name
 Father's Cell Number

 Parent's Email Address

Please list any medical conditions or allergies that we should be aware of.


 I give my son permission to attend Bar Mitzvah Club trips.

Payment: $50 (Please note: Additional fee may apply for some trips) 

 Check        Credit card - Click here

Please make check payable to:The Living Legacy                                      61 N. Ashby Avenue, Livingston, NJ, 07039