CTEEN REGISTRATION 2022 - 2023

 

I AM A TEEN (this registration is for me)
MY TEEN (I am a parent, this registration is for my teen)

 

TEEN'S INFORMATION
First name   Email
Last name   Home Phone
Address   Cell Phone
City/State  

Instagram Name 

Zip Code   Date of Birth
High School   Graduation Year

2 friends I will refer to CTeen (optional):

 

What is your preferred method of communication?
Instagram       Text Message
Email Any of the above

Size (for CTeen T-shirt)  

Did you join our Instagram page?

Yes Not Yet

Is your Mom or Dad Jewish?   How did you hear about us?

 SPONSOR A WEEK OF CTEEN 

PARENT'S INFORMATION
Mother's Name   Father's Name
Mother's Email   Father's Email