CTEEN REGISTRATION 2023 - 2024

 

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?

 

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