CTEEN REGISTRATION 2018-2019


 

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