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JUDA Registration

Full Name*
First NameLast Name
E-mail*
Phone Number*
Area CodePhone Number
Number of Child(ren) Attending*
Child/ren names & Day of Birth*
I am willing to assist in school activities, please contact me
Sliding Scale:
$60 - $180 per child for the entire year
$10 - $25 per child for upcoming program
Please consider contributing on the higher end of the scale if you have the resources to do so. This supports the sustainability of our programming, including making it possible for those families without the financial capacity to participate.
Sliding Scale Total*
$
Total Charged Now
$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

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