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Registration

Registration


CTEEN REGISTRATION 2016-2017


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 Facebook 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?
Facebook Text Message
Email Any of the above

Size (for CTeen T-shirt) Did you join the Cteen Larchmont-Mamaroneck group on Facebook? 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

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