Bar and Bat Mitzva Form - ChabadNorthQueensland

Bar and Bat Mitzva Form
Thank you for considering celebrating your child's Bar/Bat Mitzva with the Chabad North Queensland Community. We are looking forward to celebrating this milestone with you! Please fill out this form to the best of your knowledge. Contact Rabbi Ari with any questions.
Name of Child
First Name Last Name
Chosen Hebrew Name (If different from above)
Before or after sunset

Before SunsetAfter SunsetUnsure
Gender of Child
Birth Date

Month Day Year
E-mail of parent or guardian
Phone Number of parent or guardian
Father's Name
First Name Last Name
Fathers hebrew name (If different from above)
What religion was the biological father born into?
Mother's Name
First Name Last Name
Mother's hebrew name (If different from above)
What religion was the biological mother born into?
What religion was the maternal grandmother born into?
What religion was the paternal grandmother born into?
Were there any adoptions in the family history? If yes, who?
Were there any conversions in the family history? If yes, who?
Which ceremonies has the child previously had in its life?

Brit Mila (circumsission)Baby NamingPidyon HabenUpshern (3 year old traditional Hair cut)
Notes to add to application
I would like to receive news and updates by email
Should be Empty:

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