Real4Kids2 > Registration Form

Parent/Guardian Name*

Parent/Guardian Name

Address

City*

State*

Phone Number*

Email Address

Please Chose one of the following:

We DO have a mic for Class

We DO NOT have a mic for Class

Screen Name(s)

Screen Name(s)*

Student Name(s) / Age / Date of Birth*

Registration Agreement

I / We, the guardian(s)/parent(s) of the child/children registered above, agree to adhere to the rules of conduct
and attendance policies of the Yah & Yahoshua are Real4Kids2 Online Paltalk Shabbat Class. I am aware that I/We are required to monitor the usage of all minors registered.

Please Indicate Agreement by typing name(s) below

Special Note :

Welcome to Yah & Yahoshua R Real4Kids2 ! If your registration form has been submitted before Thursday 5pm Cst, it will be processed for the next upcoming Shabbat Class and you will be added to the roster. If your application is submitted after this time, you may still attend class and your child(ren) may be red- dotted.