<!DOCTYPE HTML PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">

<html xmlns="http://www.w3.org/1999/xhtml" >
<head id="Head1">
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="Content-Language" content="en" />

<meta name="keywords" content="Register,Online" />
<meta name="title" content="Register Online - Town of Oyster Bay Chabad - Center for Jewish Life Long Island" />
<meta property="og:type" content="website" />
<meta name="scope-aids" content="567107-567116-3913106-4077963" />
<meta name="article-keywords" content="2185-16403-20429-8495-21139-2170-2898" />
<meta name="scope-aid" content="567107" />
<meta name="scope-aid" content="567116" />
<meta name="scope-aid" content="3913106" />
<meta name="scope-aid" content="4077963" />
<meta name="article-keyword" content="2185" />
<meta name="article-keyword" content="16403" />
<meta name="article-keyword" content="20429" />
<meta name="article-keyword" content="8495" />
<meta name="article-keyword" content="21139" />
<meta name="article-keyword" content="2170" />
<meta name="article-keyword" content="2898" />
<meta property="og:url" content="https://www.jewishtob.org/templates/articlecco_cdo/aid/4077963/jewish/Register-Online.htm" />
<meta property="twitter:card" content="summary_large_image" />
<meta property="twitter:site" content="@chabad" />
<meta property="og:title" content="Register Online - Town of Oyster Bay Chabad - Center for Jewish Life Long Island" /><link rel="canonical" href="https://www.jewishtob.org/templates/articlecco_cdo/aid/4077963/jewish/Register-Online.htm" />
<link rel="Stylesheet" href="/css/fonts/font-awesome/font-awesome-5.css" id="kfont-awesome" type="text/css"/>
<link rel="Stylesheet" href="/css/DefaultGrid.css" id="kgrid" type="text/css"/>
<link rel="Stylesheet" href="/css/Elements.css" id="k6" type="text/css"/>
<link rel="Stylesheet" href="/css/vendor/ds/tokens/sites.css" id="ksites-ds-css" type="text/css"/>
<link rel="Stylesheet" href="/css/new/main.css" id="k7" type="text/css"/>
<link rel="Stylesheet" href="/css/old/global.css" id="k2898" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/forms/formCss2.css" id="kFormCss" type="text/css"/>
<link rel="Stylesheet" href="/css/cco/templates/forms/themes/nova.css" id="kNova" type="text/css"/>
<link rel="Stylesheet" href="/css/bootstrap/grid.css" id="kbootstrap4-grid" type="text/css"/>
<link rel="Stylesheet" href="/css/Library/reader-comments.css" id="kCommentsStylesheet" type="text/css"/>
<link rel="Stylesheet" href="/css/inline/BookInfo.css" id="kBookInfoCss" type="text/css"/>

<script>$q=[];$j=function(f){$q.push(f);}</script>
	
 
	
	<style type="text/css">
		body{margin:0;}
	</style>
	
	



<script>
	window.dataLayer = window.dataLayer || [];
	dataLayer.push({"event":"datalayer-initialized","page":{"numberOfComments":0,"publicationDate":"2018-07-10","primaryArticleId":4077963,"title":"","author":"","authorId":0,"contentLevel1":"My Site","contentLevel2":"Hebrew School","contentLevel3":"Register Online","siteName":"Town of Oyster Bay Chabad - Center for Jewish Life Long Island "},"time":{"upcomingHoliday":"The Three Weeks","daysToUpcomingHoliday":1,"hebrewDate":"5786-04-16"}});
		dataLayer.push({ 'articleHierarchy': '-567107-567116-3913106-4077963-', 'keywords': '-k2898-k2170-k21139-k8495-k20429-k16403-k2185-', 'k': '-567107-567116-3913106-4077963--k2898-k2170-k21139-k8495-k20429-k16403-k2185-' });
	
</script>
<script>

(function(c,h,a,b,a,d){c[a]=c[a]||[];c[a].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=h.getElementsByTagName(b)[0],
j=h.createElement(b);j.async=true;
j.src='https://w6.chabad.org/mitzvah-tank.js';f.parentNode.insertBefore(j,f);
})(window,document,0,'script','dataLayer');</script>

	<!-- Start of StatCounter Code -->
	<script type="text/javascript">
	var sc_project = 2936272;var sc_partition = 30;var sc_invisible = 1;var sc_remove_link=1;var sc_security = "05b1e158";var sc_https = 1;
	</script>
	<script type="text/javascript" src="https://secure.statcounter.com/counter/counter_xhtml.js" defer async></script>
	<noscript><img src="//c31.statcounter.com/counter.php?sc_project=2936272&amp;java=0&amp;security=05b1e158&amp;invisible=1" border="0" /> </noscript>
	<!-- End of StatCounter Code -->


<!-- Facebook Pixel Code -->

<noscript><img height="1" width="1" style="display:none"
  src="https://www.facebook.com/tr?id=1759786377476549&ev=PageView&noscript=1"
/></noscript>
<!-- End Facebook Pixel Code -->

<style type="text/css">
a.site_title {text-indent:-9999em;height: 100px;}
body.cco_body #header_branding {
height: 100px; 
background:url(/Media/Images/684/dNXd6841905.png) no-repeat;
margin-left:0;
}
.cco_search_header {float:right}
#header_branding > div.float_left.right_padding {
    display: none;
}
.site_title {
    margin-left: 15px !important; 
}

#tab3 {display:none;}
#top_additional_color {
background-image: url(https://w2.chabad.org/media/images/708/siYH7088647.jpeg)!important;
}
#mainArea_compact {
display: none;
}
.lo_top_bg, body {
background: url(https://w2.chabad.org/media/images/708/nfbQ7088611.jpg) repeat-x top center !important;
}
.lo_bottom_bg, #cco_body_wrap {
background: url(media/images/685/cgwe6852811.jpg) repeat-x bottom center !important;
}
#accordion {
width: 275px;
height: 280px;
margin-bottom: 10px;
} .item a, #smallservices .title, #mainarea_compact #homepage_switcher a {
background: url(https://w2.chabad.org/images/templates/template_4/Aquamarine/ui-bg_glass_100_236d91_1x400.png) repeat-x scroll 50% 50%;
color: white;
!important;
} #.lo_footer2, .lo_footer2 a {
color: 1e3a61;}
.item a, #smallservices .title, #mainarea_compact #homepage_switcher a {
    background: none;
    color: #306EA1 !important;
}
</style>

<style>
.ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder .navi a {
	color: #fff !important;
}
.ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder .navi a:hover {
	color: #ffe89b !important;
}
</style>



<style type="text/css" rel="stylesheet">
/*<![CDATA[*//**/
@import url("https://fundapp.io/sites/chabad_tob/css/header.css");
/**/
}/*]]>*/</style>


<!--
<div id="donate-m-container">
<div id="donate-m"><a href="/match">DONATE</a></div>
</div>-->
<script>
  !function(f,b,e,v,n,t,s)
  {if(f.fbq)return;n=f.fbq=function(){n.callMethod?
  n.callMethod.apply(n,arguments):n.queue.push(arguments)};
  if(!f._fbq)f._fbq=n;n.push=n;n.loaded=!0;n.version='2.0';
  n.queue=[];t=b.createElement(e);t.async=!0;
  t.src=v;s=b.getElementsByTagName(e)[0];
  s.parentNode.insertBefore(t,s)}(window, document,'script',
  'https://connect.facebook.net/en_US/fbevents.js');
  fbq('init', '1759786377476549');
  fbq('track', 'PageView');
</script><script>
  (function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){
  (i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),
  m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)
  })(window,document,'script','//www.google-analytics.com/analytics.js','ga');

  ga('create', 'UA-56623213-1', 'auto');
  ga('send', 'pageview');

</script><title>
	Register Online - Town of Oyster Bay Chabad - Center for Jewish Life Long Island 
</title></head>
<body class="lang_en dir_ltr cco_body form secure cco_templateless_page section_branch">
	
	
		<div width="100%" class="cco_templateless_template" style="z-index:100 !important;display:block !important;left:0px !important;top:0px !important;height:30px!important;width:100% !important;line-height:30px !important; position:relative !important; margin-bottom:0 !important; padding:0;text-indent: 25px;" align="Left"><a href="//www.JewishTOB.org" style="display:block!important;font-size:14px !important;">&laquo; Back to&nbsp;Town of Oyster Bay Chabad - Center for Jewish Life Long Island </a></div>
	
	<div class="cco_templatelates_content">
		
	<div class="co_content_container clearfix local_content" id="co_content_container">
		<div class="clearfix">
			<!-- BEGIN HEADER --><style>

@charset "UTF-8";
@import url("https://fonts.googleapis.com/css?family=Work+Sans:400,700");
#co_video_container .co_body, .co_content_container {
  padding: 0; }

body #tabContentMain .co_menu_item, body.cco_body #tabContentMain .co_menu_item {
  border-bottom: 0; }

.co_menu_container #tabContentMain, .co_menu_container #tabContentPartner {
  border-bottom: 0; }

.text-xs-left {
  text-align: left; }

.text-xs-right {
  text-align: right; }

.text-xs-center {
  text-align: center; }

.text-xs-justify {
  text-align: justify; }

.vertical-align {
  display: -webkit-box;
  display: -ms-flexbox;
  display: flex;
  -webkit-box-align: center;
      -ms-flex-align: center;
          align-items: center; }

.vertical-align-xs {
  display: -webkit-box;
  display: -ms-flexbox;
  display: flex;
  -webkit-box-align: center;
      -ms-flex-align: center;
          align-items: center; }

.align-self-center {
  margin-left: auto;
  margin-right: auto; }

.align-self-center-xs {
  margin-left: auto;
  margin-right: auto; }

.no-align-self {
  margin-left: 0;
  margin-right: 0; }

.no-align-self-xs {
  margin-left: 0;
  margin-right: 0; }

@media (min-width: 768px) {
  .text-sm-left {
    text-align: left; }
  .text-sm-right {
    text-align: right; }
  .text-sm-center {
    text-align: center; }
  .text-sm-justify {
    text-align: justify; }
  .vertical-align-sm {
    display: -webkit-box;
    display: -ms-flexbox;
    display: flex;
    -webkit-box-align: center;
        -ms-flex-align: center;
            align-items: center; }
  .align-self-center-sm {
    margin-left: auto;
    margin-right: auto; }
  .no-align-self-sm {
    margin-left: 0;
    margin-right: 0; } }

@media (min-width: 992px) {
  .text-md-left {
    text-align: left; }
  .text-md-right {
    text-align: right; }
  .text-md-center {
    text-align: center; }
  .text-md-justify {
    text-align: justify; }
  .vertical-align-md {
    display: -webkit-box;
    display: -ms-flexbox;
    display: flex;
    -webkit-box-align: center;
        -ms-flex-align: center;
            align-items: center; }
  .align-self-center-md {
    margin-left: auto;
    margin-right: auto; }
  .no-align-self-md {
    margin-left: 0;
    margin-right: 0; } }

@media (min-width: 1200px) {
  .text-lg-left {
    text-align: left; }
  .text-lg-right {
    text-align: right; }
  .text-lg-center {
    text-align: center; }
  .text-lg-justify {
    text-align: justify; }
  .vertical-align-lg {
    display: -webkit-box;
    display: -ms-flexbox;
    display: flex;
    -webkit-box-align: center;
        -ms-flex-align: center;
            align-items: center; }
  .align-self-center-lg {
    margin-left: auto;
    margin-right: auto; }
  .no-align-self-lg {
    margin-left: 0;
    margin-right: 0; } }

/* No Gutters
.row.no-gutters {
  margin-right: 0;
  margin-left: 0;
}
.row.no-gutters &#x003E; [class^="col-"],
.row.no-gutters &#x003E; [class*=" col-"] {
  padding-right: 0;
  padding-left: 0;
}*/
body {
  background: none !important;
  overflow-x: hidden;
  max-width: 100vw; }

p, div {
  font-family: "Work Sans", sans-serif; }

.ct-container {
  margin-bottom: 0;
  font-family: "Work Sans", sans-serif; }
  .ct-container, .ct-container * {
    box-sizing: border-box; }
  .ct-container h3 {
    font-family: "Lora", sans-serif;
    text-transform: uppercase;
    font-size: 52px;
    font-weight: bold; }
  .ct-container h4, .ct-container .form-header {
    font-family: "Lora", sans-serif;
    text-transform: uppercase;
    font-size: 24px; }
  @media (max-width: 991px) {
    .ct-container .fs-sm-hide-break {
      display: block;
      font-size: 0; } }
  @media (max-width: 767px) {
    .ct-container .fs-xs-hide-break {
      display: block;
      font-size: 0; } }
  @media (max-width: 450px) {
    .ct-container .fs-xxs-hide-break {
      display: block;
      font-size: 0; } }

.ct-container .ct-content .form-submit-button, .ct-container .ct-content .form-submit-print, .ct-container .ct-content .form-submit-reset,
.ct-container .fs-btn {
  margin-top: 20px;
  background: #008759;
  border-radius: 0;
  border: 0;
  text-shadow: none;
  font-size: 1.4em;
  transition: all 300ms;
  border-radius: 0;
  padding: 0.4em 1.1em;
  text-transform: uppercase;
  color: #FFFFFF;
  font-weight: bold; }
  .ct-container .ct-content .form-submit-button .glyphicon, .ct-container .ct-content .form-submit-print .glyphicon, .ct-container .ct-content .form-submit-reset .glyphicon,
  .ct-container .fs-btn .glyphicon {
    font-size: 2rem; }
  .ct-container .ct-content .form-submit-button:hover, .ct-container .ct-content .form-submit-button:focus, .ct-container .ct-content .form-submit-button:active, .ct-container .ct-content .form-submit-print:hover, .ct-container .ct-content .form-submit-print:focus, .ct-container .ct-content .form-submit-print:active, .ct-container .ct-content .form-submit-reset:hover, .ct-container .ct-content .form-submit-reset:focus, .ct-container .ct-content .form-submit-reset:active,
  .ct-container .fs-btn:hover,
  .ct-container .fs-btn:focus,
  .ct-container .fs-btn:active {
    background: #005437;
    color: #FFFFFF; }

.ct-facebook-image {
  display: none; }

.ct-container {
  background: #1EA69C url("https://w2.chabad.org/media/images/1040/BzqW10403176.jpg");
  background-size: cover;
  background-position: center;
  padding-bottom: 1px;
  position: relative;
  z-index: 301;
  width: 100vw;
  overflow: hidden;
  margin-top: -30px; }
  .ct-container:before {
    background: url("https://w2.chabad.org/media/images/1040/hGJN10403182.png");
    background-size: contain;
    background-position: top left;
    background-repeat: no-repeat;
    position: absolute;
    top: 0;
    left: 0;
    width: 240px;
    height: 200px;
    content: " "; }
    @media (max-width: 1600px) {
      .ct-container:before {
        left: -20px;
        width: 200px; } }
    @media (max-width: 500px) {
      .ct-container:before {
        left: -100px; } }
  .ct-container:after {
    background: url("https://w2.chabad.org/media/images/1040/PjRY10403184.png");
    background-size: contain;
    background-position: top left;
    background-repeat: no-repeat;
    position: absolute;
    top: 0;
    right: 0;
    width: 180px;
    height: 160px;
    content: " "; }
    @media (max-width: 1130px) {
      .ct-container:after {
        top: -10px;
        width: 100px; } }
  .ct-container .ct-facebook {
    display: none; }

.ct-header-back {
  background-repeat: no-repeat;
  background-size: 100%;
  background-position: top center;
  position: absolute;
  top: 0px;
  width: 100%;
  overflow: hidden; }

.ct-header, .ct-header-back {
  height: 200px;
  z-index: 300; }

.ct-header {
  position: relative;
  z-index: 302;
  padding-top: 0px;
  padding-top: 21px; }
  .ct-header .ct-illustration-rocket {
    position: absolute;
    top: 5vw;
    right: 5%;
    max-width: 20%; }
    @media (max-width: 1500px) {
      .ct-header .ct-illustration-rocket {
        right: 2%;
        top: 7vw; } }
    @media (max-width: 1400px) {
      .ct-header .ct-illustration-rocket {
        top: 10vw; } }
    @media (max-width: 1130px) {
      .ct-header .ct-illustration-rocket {
        right: -2%;
        top: 12vw;
        max-width: 22%; } }
    @media (max-width: 800px) {
      .ct-header .ct-illustration-rocket {
        display: none; } }
  @media (min-width: 1131px) {
    .ct-header:after {
      content: 'ב"ה';
      color: #fff;
      opacity: 0.6;
      font-family: "Work Sans", sans-serif;
      font-size: 13px;
      position: absolute;
      top: 10px;
      right: 28px;
      display: inline-block; } }
  .ct-header .ct-header-inner {
    width: 90%;
    height: 100%;
    margin: 0 auto;
    max-width: 1120px;
    position: relative; }
    .ct-header .ct-header-inner .ct-logo-mobile {
      display: none; }
    @media (max-width: 1130px) {
      .ct-header .ct-header-inner .ct-logo-mobile {
        text-align: center;
        display: inline-block;
        position: absolute;
        left: 50%;
        -webkit-transform: translateX(-50%);
                transform: translateX(-50%); }
        .ct-header .ct-header-inner .ct-logo-mobile img {
          display: inline-block;
          width: 100px; } }
  .ct-header .ct-nav {
    right: 0;
    position: absolute;
    top: 50%;
    left: 50%;
    -webkit-transform: translate(-50%, -50%);
            transform: translate(-50%, -50%);
    width: 100%;
    text-align: center; }
    .ct-header .ct-nav .ct-toggle-mobile-nav-label-inside-nav,
    .ct-header .ct-nav .ct-toggle-mobile-nav-label-backoverlay,
    .ct-header .ct-nav .ct-toggle-mobile-nav-label,
    .ct-header .ct-nav .ct-toggle-mobile-nav {
      display: none; }
    .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi {
      padding: 0;
      margin: 0; }
      .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent {
        float: none;
        margin: 0;
        padding: 0;
        list-style: none;
        display: inline-block;
        vertical-align: middle;
        font-size: 0;
        position: relative; }
        .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent a.parent {
          color: #FFFFFF;
          font-family: "Work Sans", sans-serif;
          text-transform: uppercase;
          font-size: 16px;
          letter-spacing: 2px;
          padding: 15px 11px 20px;
          display: block;
          text-decoration: none; }
          .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent a.parent:hover {
            text-decoration: none;
            color: #ffe89b; }
          .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent a.parent.selected {
            color: #FFD135; }
          .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent a.parent:focus {
            outline-color: #fff; }
        .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent a.parent[href*="3913109"] {
          width: 165px;
          height: 165px;
          text-indent: -9999px;
          background: url("https://w2.chabad.org/media/images/1040/cPmU10403198.png");
          background-size: contain;
          background-position: center;
          margin-left: 20px;
          margin-right: 20px; }
          @media (max-width: 1130px) {
            .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent a.parent[href*="3913109"] {
              display: none; } }
        .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent .sub_menu {
          display: none;
          position: absolute;
          left: 50%;
          -webkit-transform: translateX(-50%);
                  transform: translateX(-50%);
          min-width: 100%;
          background: #008759;
          padding-top: 3px;
          padding-bottom: 3px; }
          .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent .sub_menu ul {
            padding-left: 0;
            width: 100%; }
          .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent .sub_menu li a {
            font-size: 16px;
            min-width: 175px;
            display: inline-block;
            padding: 4px 15px 7px;
            text-decoration: none;
            color: #fff; }
        .ct-header .ct-nav .ct-nav-inner .chabad_menu_content .navi .item.parent:hover .sub_menu {
          display: block; }
    @media (max-width: 1130px) {
      .ct-header .ct-nav {
        position: absolute;
        -webkit-transform: none;
                transform: none;
        left: auto;
        top: 0px;
        right: 5px;
        display: inline-block;
        width: 50px;
        float: right; }
        .ct-header .ct-nav .ct-nav-inner {
          text-align: left; }
          .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav-label-backoverlay {
            width: 100%;
            height: 100%;
            position: fixed;
            top: 0;
            left: 0;
            background: rgba(30, 166, 156, 0.9);
            display: none; }
          .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav-label {
            display: block;
            cursor: pointer;
            padding: 25px; }
            .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav-label:after {
              content: "\f0c9";
              font-family: "FontAwesome";
              font-size: 24px;
              color: #fff; }
          .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav-label-inside-nav {
            display: block;
            text-align: right;
            cursor: pointer;
            padding: 15px;
            float: right;
            margin-top: -10px;
            margin-right: -10px;
            margin-bottom: -10px;
            /*.mobile & {
                            margin-right: 10px;
                        }*/ }
            .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav-label-inside-nav:after {
              content: "\f00d";
              font-family: "FontAwesome";
              font-size: 24px;
              color: #fff; }
          .ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder {
            position: fixed;
            top: 0;
            right: -340px;
            /*.mobile & {
                            right: -300px;
                        }*/
            background: #008759;
            padding: 10px;
            margin: 0;
            -webkit-transform: none;
                    transform: none;
            width: 300px;
            max-width: 90%;
            height: 100vh;
            overflow: auto;
            transition: right 300ms; }
            .ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder .navi .item.parent {
              width: 100%;
              margin: 0; }
              .ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder .navi .item.parent a.parent {
                color: #fff; }
                .ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder .navi .item.parent a.parent.selected {
                  color: #FFD135; }
              .ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder .navi .item.parent .sub_menu {
                display: block;
                position: relative;
                margin-bottom: 12px;
                padding-top: 0;
                padding-bottom: 0; }
                .ct-header .ct-nav .ct-nav-inner .ct-nav-links-holder .navi .item.parent .sub_menu li a {
                  font-size: 13px;
                  padding-left: 10px; }
          .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav:checked ~ {
            /*.mobile & .ct-nav-links-holder {
                            right: 298px;
                        }*/ }
            .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav:checked ~ .ct-toggle-mobile-nav-label-backoverlay {
              display: block; }
            .ct-header .ct-nav .ct-nav-inner .ct-toggle-mobile-nav:checked ~ .ct-nav-links-holder {
              right: 0; } }

@media only screen and (min-width: 320px) {
  .ct-content .content .co_body {
    margin-left: 0;
    margin-right: 0; } }

.ct-content #content_page_full,
.ct-content #content_page {
  width: 90%;
  margin: 30px auto;
  padding: 70px 70px 70px;
  max-width: 940px;
  background: #fff;
  margin-bottom: 0px;
  padding-bottom: 500px; }
  @media (max-width: 700px) {
    .ct-content #content_page_full,
    .ct-content #content_page {
      padding: 30px 30px; } }
  @media (max-width: 1130px) {
    .ct-content #content_page_full,
    .ct-content #content_page {
      margin-top: -65px; } }
  @media (max-width: 700px) {
    .ct-content #content_page_full,
    .ct-content #content_page {
      padding-bottom: 70vw; } }
  @media (max-width: 500px) {
    .ct-content #content_page_full,
    .ct-content #content_page {
      padding-bottom: 100vw; } }
  .ct-content #content_page_full #cco_body,
  .ct-content #content_page #cco_body {
    min-height: 400px;
    position: relative;
    z-index: 1; }
  .ct-content #content_page_full .content,
  .ct-content #content_page .content {
    overflow: visible; }
  @media (max-width: 600px) {
    .ct-content #content_page_full,
    .ct-content #content_page {
      width: 100%; } }

.ct-content .form-header-group,
.ct-content .SCHeading_1 {
  font-size: 32px;
  font-family: "Work Sans", sans-serif;
  font-weight: bold;
  color: #008759; }
  .ct-content .form-header-group:first-child,
  .ct-content .SCHeading_1:first-child {
    margin-top: 0; }

.ct-content .form-header-group {
  font-size: 18px; }

.ct-content p {
  line-height: 140%;
  font-size: 15px; }

.ct-content img {
  max-width: 100%; }

.ct-content label {
  font-weight: normal; }

.ct-content .form-label-left label {
  font-weight: bold; }

.ct-content .form-header-group,
.ct-content .form-line {
  padding-left: 0;
  padding-right: 0;
  margin-left: 0;
  margin-right: 0;
  border: none; }

.ct-content .form-all .ct-page-header {
  margin-top: -15px;
  margin-left: -73px;
  margin-right: -73px;
  width: calc(100% + 146px);
  margin-bottom: 50px; }
  .mobile .ct-content .form-all .ct-page-header {
    margin-top: -22px; }
  @media (max-width: 700px) {
    .ct-content .form-all .ct-page-header {
      margin-left: -33px;
      margin-right: -33px;
      width: calc(100% + 66px);
      margin-bottom: 20px; } }

@media only screen and (max-device-width: 550px) and (max-width: 550px) {
  .ct-content .form-section, .ct-content .form-section-closed {
    margin: 0; } }

.ct-content .article_index .item {
  background: none; }
  .ct-content .article_index .item .inner {
    width: 100%; }
    .ct-content .article_index .item .inner .title, .ct-content .article_index .item .inner .title a {
      color: #008759; }

.ct-home {
  width: 100%;
  margin: 0px auto;
  text-align: center;
  max-width: 1100px;
  position: relative;
  z-index: 3; }
  @media (max-width: 1550px) {
    .ct-home {
      min-height: 0; } }
  @media (min-width: 1550px) {
    .ct-home {
      min-height: 45vw; } }
  @media (min-width: 1798px) {
    .ct-home {
      min-height: 814px; } }

@-webkit-keyframes popinanimation1 {
  0% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }

@keyframes popinanimation1 {
  0% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }

@-webkit-keyframes popinanimation2 {
  0%, 40% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }

@keyframes popinanimation2 {
  0%, 40% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }

@-webkit-keyframes popinanimation3 {
  0%, 50% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }

@keyframes popinanimation3 {
  0%, 50% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }

@-webkit-keyframes popinanimation4 {
  0%, 60% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }

@keyframes popinanimation4 {
  0%, 60% {
    -webkit-transform: scale(0.7);
            transform: scale(0.7);
    opacity: 0; }
  100% {
    -webkit-transform: scale(1);
            transform: scale(1);
    opacity: 1; } }
  .ct-home .ct-home-content .ct-home-title {
    max-width: 85%;
    margin-top: 30px;
    -webkit-animation: popinanimation1 550ms;
            animation: popinanimation1 550ms;
    margin-bottom: 10px; }
    @media (max-width: 1130px) {
      .ct-home .ct-home-content .ct-home-title {
        margin-top: -40px; } }
  .ct-home .ct-home-content .ct-home-text {
    color: #fff;
    font-size: 23px;
    font-family: "Work Sans", sans-serif;
    -webkit-animation: popinanimation2 750ms;
            animation: popinanimation2 750ms;
    margin-bottom: 40px;
    max-width: 660px;
    line-height: 130%;
    width: 85%;
    margin: 0px auto 36px; }
    @media (max-width: 650px) {
      .ct-home .ct-home-content .ct-home-text {
        font-size: 20px; } }
  .ct-home .ct-home-content .ct-home-buttons a {
    display: inline-block;
    margin: 0 10px 10px;
    color: #333;
    text-decoration: none;
    border: 2px solid;
    border-color: #F9D24E;
    background: #F9D24E;
    text-transform: uppercase;
    font-weight: bold;
    min-width: 180px;
    border-radius: 30px;
    padding: 10px 30px;
    font-size: 24px;
    transition: -webkit-transform 300ms;
    transition: transform 300ms;
    -webkit-transform: scale(0.98);
            transform: scale(0.98);
    -webkit-font-smoothing: antialiased;
    position: relative;
    -webkit-animation: popinanimation4 1300ms;
            animation: popinanimation4 1300ms; }
    .ct-home .ct-home-content .ct-home-buttons a:focus, .ct-home .ct-home-content .ct-home-buttons a:hover {
      -webkit-transform: scale(1.04);
              transform: scale(1.04); }
    .ct-home .ct-home-content .ct-home-buttons a:focus {
      outline-color: #fff; }
    .ct-home .ct-home-content .ct-home-buttons a:active {
      top: -1px; }
    @media (max-width: 650px) {
      .ct-home .ct-home-content .ct-home-buttons a {
        font-size: 20px;
        padding: 14px 27px;
        margin: 0 auto 10px;
        display: block;
        width: 50%; } }
  .ct-home .ct-home-content .ct-home-buttons a:first-child {
    background: none;
    color: #fff;
    border-color: #fff;
    -webkit-animation: popinanimation3 1100ms;
            animation: popinanimation3 1100ms; }
  @media (max-width: 1650px) {
    .ct-home .ct-home-content {
      margin-bottom: 50px; } }
  @media (max-width: 1550px) {
    .ct-home .ct-home-content {
      margin-bottom: 380px; } }
  @media (max-width: 1250px) {
    .ct-home .ct-home-content {
      margin-bottom: 400px; } }
  @media (max-width: 1000px) {
    .ct-home .ct-home-content {
      margin-bottom: 430px; } }
  @media (max-width: 850px) {
    .ct-home .ct-home-content {
      margin-bottom: 450px; } }
  @media (max-width: 700px) {
    .ct-home .ct-home-content {
      margin-bottom: 80vw; } }
  @media (max-width: 500px) {
    .ct-home .ct-home-content {
      margin-bottom: 110vw; } }

/*@mixin moveinfromright($name, $right, $bottom: 0) {
    @keyframes $name {
        from {margin-right: $right; margin-bottom: $bottom;}
            to {margin-right:  0; margin-bottom: 0;}
    }
}
@mixin moveinfromleft($name, $right, $bottom: 0) {
    @keyframes $name {
        from {margin-left: $right; margin-bottom: $bottom;}
            to {margin-left:  0; margin-bottom: 0;}
    }
}*/
.ct-footer-illustrations {
  position: absolute;
  bottom: -1px;
  width: 100%; }
  .ct-footer-illustrations img {
    position: absolute; }
  .ct-footer-illustrations .ct-footer-illustration-carousel {
    left: 0;
    bottom: 8vw;
    max-width: 36%; }
    @media (max-width: 1650px) {
      .ct-footer-illustrations .ct-footer-illustration-carousel {
        left: -3vw; } }
    @media (max-width: 1560px) {
      .ct-footer-illustrations .ct-footer-illustration-carousel {
        left: -7vw; } }
    @media (max-width: 1500px) {
      .ct-footer-illustrations .ct-footer-illustration-carousel {
        left: -12vw; } }
    @media (max-width: 1400px) {
      .ct-footer-illustrations .ct-footer-illustration-carousel {
        left: -13vw; } }
    @media (max-width: 1300px) {
      .ct-footer-illustrations .ct-footer-illustration-carousel {
        left: -17vw; } }
    @media (max-width: 700px) {
      .ct-footer-illustrations .ct-footer-illustration-carousel {
        max-width: 40%;
        bottom: 4vw;
        left: 0; } }
    @media (max-width: 500px) {
      .ct-footer-illustrations .ct-footer-illustration-carousel {
        max-width: 55%; } }
  .ct-footer-illustrations .ct-footer-illustration-shabbat {
    left: 11%;
    bottom: 0%;
    max-width: 30%; }
    @media (max-width: 1000px) {
      .ct-footer-illustrations .ct-footer-illustration-shabbat {
        left: 20%;
        bottom: 2%; } }
    @media (max-width: 700px) {
      .ct-footer-illustrations .ct-footer-illustration-shabbat {
        left: 32%;
        bottom: 2%; } }
    @media (max-width: 500px) {
      .ct-footer-illustrations .ct-footer-illustration-shabbat {
        display: none; } }
  .ct-footer-illustrations .ct-footer-illustration-hill-left {
    left: 0;
    bottom: 3%;
    max-width: 75%; }
    @media (max-width: 500px) {
      .ct-footer-illustrations .ct-footer-illustration-hill-left {
        bottom: 2vw; } }
  .ct-footer-illustrations .ct-footer-illustration-hill-right {
    right: 0;
    bottom: 2.2vw;
    max-width: 75%; }
    @media (max-width: 500px) {
      .ct-footer-illustrations .ct-footer-illustration-hill-right {
        bottom: 2vw; } }
  .ct-footer-illustrations .ct-footer-illustration-rock-small {
    right: 22%;
    bottom: 3%;
    max-width: 14%; }
    @media (max-width: 1000px) {
      .ct-footer-illustrations .ct-footer-illustration-rock-small {
        display: none; } }
  .ct-footer-illustrations .ct-footer-illustration-rock-large {
    right: 0%;
    bottom: 6vw;
    max-width: 18%; }
    @media (max-width: 1300px) {
      .ct-footer-illustrations .ct-footer-illustration-rock-large {
        display: none; } }
  .ct-footer-illustrations .ct-footer-illustration-soccer-boy {
    right: 6%;
    bottom: 16vw;
    max-width: 22%; }
    @media (max-width: 1600px) {
      .ct-footer-illustrations .ct-footer-illustration-soccer-boy {
        bottom: 20vw;
        right: 2%; } }
    @media (max-width: 1300px) {
      .ct-footer-illustrations .ct-footer-illustration-soccer-boy {
        bottom: 27vw; } }
    @media (max-width: 700px) {
      .ct-footer-illustrations .ct-footer-illustration-soccer-boy {
        bottom: 22vw;
        max-width: 30%;
        right: 2%; } }
    @media (max-width: 500px) {
      .ct-footer-illustrations .ct-footer-illustration-soccer-boy {
        max-width: 37%;
        bottom: 20vw; } }
  .ct-footer-illustrations .ct-footer-illustration-tennis-girl {
    right: 8%;
    bottom: 2%;
    max-width: 22%; }
    @media (max-width: 800px) {
      .ct-footer-illustrations .ct-footer-illustration-tennis-girl {
        display: none; } }
  .ct-footer-illustrations .ct-footer-illustration-swim {
    right: 32%;
    bottom: 3vw;
    max-width: 20%; }
    @media (max-width: 1500px) {
      .ct-footer-illustrations .ct-footer-illustration-swim {
        right: 42%; } }
    @media (max-width: 1100px) {
      .ct-footer-illustrations .ct-footer-illustration-swim {
        display: none; } }
  .ct-footer-illustrations .ct-footer-illustration-grass-small {
    right: 43%;
    bottom: 1.8vw;
    max-width: 10%; }
    @media (max-width: 1500px) {
      .ct-footer-illustrations .ct-footer-illustration-grass-small {
        right: 53%;
        bottom: 1.6vw; } }
    @media (max-width: 1100px) {
      .ct-footer-illustrations .ct-footer-illustration-grass-small {
        display: none; } }
  .ct-footer-illustrations .ct-footer-illustration-bottom-grass {
    left: 50%;
    bottom: 0px;
    width: 101%;
    min-width: 1500px;
    -webkit-transform: translatex(-50%);
            transform: translatex(-50%); }
    @media (max-width: 500px) {
      .ct-footer-illustrations .ct-footer-illustration-bottom-grass {
        min-width: 1000px; } }

#BodyContainer, #BodyContainer .footer {
  width: 100%;
  text-align: center;
  overflow: hidden; }

#BodyContainer .footer {
  margin-left: 0;
  padding: 0 40px;
  background: #008759;
  color: #ffffff;
  position: relative;
  z-index: 302; }
  #BodyContainer .footer .site-by {
    display: none; }
  #BodyContainer .footer .cs-back-to {
    margin-bottom: 10px; }
  #BodyContainer .footer.g960 {
    float: none;
    width: 100%;
    display: block;
    padding-left: 0px;
    padding-right: 0px; }
  .mobile #BodyContainer .footer {
    float: left;
    overflow: hidden; }
  #BodyContainer .footer .poweredby {
    padding-top: 25px;
    padding-bottom: 18px;
    padding-left: 30px;
    padding-right: 30px; }
    #BodyContainer .footer .poweredby, #BodyContainer .footer .poweredby b {
      font-family: "Work Sans", sans-serif;
      font-weight: normal; }
    #BodyContainer .footer .poweredby b {
      font-size: 12px; }
  #BodyContainer .footer a {
    color: #ffffff;
    text-decoration: underline; }
    #BodyContainer .footer a:focus {
      outline-color: #fff; }
</style>

<meta name="viewport" content="width=device-width, initial-scale=1" />
<meta charset="utf-8" />

<div id="fb-root"></div>



<meta name="theme-color" content="#1EA49D" />

<div class="ct-container">
<img src="https://w2.chabad.org/media/images/1040/pxRZ10403221.jpg" class="ct-facebook" />
<div class="ct-header-back">
&#160;
</div>
<div class="ct-header">

<img src="https://w2.chabad.org/media/images/1040/wvOn10403204.png" class="ct-illustration-rocket" />

<div class="ct-header-inner">

<div class="ct-logo-mobile ct-logo-shadow">
<a href="/3913109" class="ct-logo">
<img src="https://w2.chabad.org/media/images/1040/cPmU10403198.png" /></a>
</div>

<div class="ct-nav">
<div class="ct-nav-inner">
<input type="checkbox" class="ct-toggle-mobile-nav" id="ToggleMobileNav" />
<label for="ToggleMobileNav" class="ct-toggle-mobile-nav-label-backoverlay"></label>
<label for="ToggleMobileNav" class="ct-toggle-mobile-nav-label">  &#160;
</label>

<div class="ct-nav-links-holder">
<label for="ToggleMobileNav" class="ct-toggle-mobile-nav-label-inside-nav"></label>


<div id="navigation" class="chabad_navigator_bar">
<div class="chabad_menu_content">
<ul id="menu" class="navi">
<li class="item parent">
<a href="/article.asp?aid=3913106" class="parent">Home</a>
|
</li>
<li class="item parent arrow">
<a href="/article.asp?aid=1267455" class="parent arrow">About</a>
<div class="sub_menu">
<ul>
<li class="item first">
<a href="/article.asp?aid=1267457">Aleph Champ</a>
</li>
<li class="item">
<a href="/article.asp?aid=1449076">FAQ</a>
</li>
<li class="item">
<a href="/article.asp?aid=571024">Kids Zone</a>
</li>
<li class="item">
<a href="/article.asp?aid=1443834">Testimonials </a>
</li>
<li class="item">
<a href="/article.asp?aid=1274805">Curriculum</a>
</li>
<li class="item">
<a href="/article.asp?aid=4138655">Aleph Champ Homework</a>
</li>
<li class="item last">
<a href="/article.asp?aid=4505571">Bar/Bat Mitzvah Ceremony</a>
</li>
</ul>
</div>
|
</li>
<li class="item parent selected">
<a href="/article.asp?aid=4077963" class="parent selected">Register Online</a>
|
</li>
<li class="item parent">
<a href="/article.asp?aid=3802707" class="parent">Calendar</a>
|
</li>
<li class="item parent arrow">
<a href="/article.asp?aid=892942" class="parent arrow">Photos</a>
<div class="sub_menu">
<ul>
<li class="item first">
<a href="/article.asp?aid=3876810">Hebrew School 5778</a>
</li>
<li class="item">
<a href="/article.asp?aid=2924492">Hebrew School 2014-2015</a>
</li>
<li class="item">
<a href="/article.asp?aid=1873561">Hebrew School Graduation 2012</a>
</li>
<li class="item">
<a href="/article.asp?aid=1833501">Hebrew School Spring 2012</a>
</li>
<li class="item">
<a href="/article.asp?aid=1530978">Hebrew School Graduation 2011</a>
</li>
<li class="item">
<a href="/article.asp?aid=1436485">Hebrew School Jewish Know It All Bee</a>
</li>
<li class="item">
<a href="/article.asp?aid=1378920">Hebrew School Chanukah 2010 </a>
</li>
<li class="item">
<a href="/article.asp?aid=1294654">Hebrew School Graduation 2010</a>
</li>
<li class="item">
<a href="/article.asp?aid=1000656">Hebrew School 2010</a>
</li>
<li class="item">
<a href="/article.asp?aid=887573">Hebrew School 2009</a>
</li>
<li class="item">
<a href="/article.asp?aid=608899">Hebrew School Chanukah '07 and Passover '08 Pictures</a>
</li>
<li class="item last">
<a href="/article.asp?aid=593108">Hebrew School Fall 2007 Pictures</a>
</li>
</ul>
</div>
|
</li>
<li class="item parent">
<a href="/article.asp?aid=3913718" class="parent">Contact</a>
</li>

</ul>
</div>
</div>



</div>

</div>
</div>
</div>

</div>

<div class="ct-content-wrapper">
<div class="ct-content"><div detached="true" type="static" id="ContentArea" name="content_area" actions="edit,delete" class="content"><div id="content_page" class="content_page"><!-- END HEADER -->
			
			
			<div class="clearfix bh mobile-only align_right">ב"ה</div>
			
				<div class="master-content-wrapper " >
					

<header class="article-header cf ">
	
	
			<h1 class="article-header__title js-article-title js-page-title">Register Online</h1>
		
			<div>
				
			</div>
		
</header>
				</div>
			
			<div class="body_wrapper clearfix co_body">
				<div class="" id="co_body_container">
					
					<div id="ContentBody">
						
						
							<div class="content-area-parent no_margin">
								
	<div id="cco_body">
		<div class="content  no_margin no_overflow" id="co_content_container">
			
			
	

	<article class="content js-content" >
	

<div id="formContainer"><script type="text/javascript">var defaultCurrency = { value: 'USD', symbol: '$'};
$j(function(){
window.multiplier = 0;
window.formJson = Object.extend([{"form_height":450,"64_text":"\u003cp\u003e\u003cstrong\u003eEnroll your child in the Hebrew School where kids don\u0027t want to miss a day!\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eAt Aleph Champ Hebrew School we try to keep the admissions process as simple as possible. We also offer several opportunities to get to know the school, before you apply. Please contact us for more information.\u0026#160;\u003cbr\u003e\u003cbr\u003eComplete the form below. If you have any questions, we\u0027ll be happy to help!\u003c/p\u003e\u003cp\u003eRabbi Shalom Lipszyc - 347 853 9992\u003c/p\u003e\u003cp\u003e\u003cspan style=\"font-size: 12px;\"\u003e\u003cem\u003eDue to limited space and a high number of applicants each year, we are unfortunately unable to accept every child for admission. Applications are processed in the order they are received.\u003c/em\u003e\u003c/span\u003e\u003c/p\u003e","64_name":"doubleclickTo64","64_qid":64,"64_type":"control_text","64_order":1,"9_text":"1. Child/ren’s Information","9_subHeader":"","9_headerType":"Default","9_name":"clickTo","9_qid":9,"9_type":"control_head","9_order":2,"3_text":"Child 1","3_message":"","3_labelAlign":"Top","3_required":"Yes","3_prefix":"No","3_suffix":"No","3_middle":"Yes","3_description":"","3_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"3_readonly":"No","3_name":"child1","3_qid":3,"3_type":"control_fullname","3_order":3,"3_shrink":"Yes","67_text":"","67_message":"","67_labelAlign":"Auto","67_required":"No","67_size":20,"67_validation":"None","67_maxsize":"","67_inputTextMask":"","67_defaultValue":"","67_subLabel":"Hebrew Name","67_hint":" ","67_description":"","67_readonly":"No","67_name":"input67","67_qid":67,"67_type":"control_textbox","67_order":4,"27_text":"Birth Date","27_message":"","27_labelAlign":"Top","27_required":"Yes","27_format":"mmddyyyy","27_yearFrom":"","27_yearTo":"","27_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"27_description":"","27_sublabels":{"month":"Month","day":"Day","year":"Year"},"27_name":"birthDate27","27_qid":27,"27_type":"control_birthdate","27_order":5,"27_shrink":"Yes","19_text":"Gender","19_message":"","19_labelAlign":"Top","19_required":"Yes","19_options":"Male|Female","19_special":"None","19_allowOther":"No","19_otherText":"Other","19_calculateOther":"No","19_selected":"","19_spreadCols":"1","19_description":"","19_name":"gender","19_qid":19,"19_type":"control_radio","19_order":6,"19_shrink":"Yes","77_text":"Child...","77_message":"","77_labelAlign":"Auto","77_required":"Yes","77_options":"\u0027s Natural Mother is Jewish|converted to Judaism|is adopted","77_special":"None","77_allowOther":"Yes","77_otherText":"Other","77_calculateOther":"No","77_selected":"","77_spreadCols":"3","77_description":"","77_name":"input77","77_qid":77,"77_type":"control_radio","77_order":7,"77_pricing":"0|0|0","76_text":"Child Reads Basic Hebrew?","76_message":"","76_labelAlign":"Auto","76_required":"Yes","76_options":"Yes|No","76_special":"None","76_allowOther":"No","76_otherText":"Other","76_calculateOther":"No","76_selected":"","76_spreadCols":"1","76_description":"","76_name":"input76","76_qid":76,"76_type":"control_radio","76_order":8,"72_text":"School Attending","72_message":"","72_labelAlign":"Auto","72_required":"Yes","72_size":20,"72_validation":"None","72_maxsize":"","72_inputTextMask":"","72_defaultValue":"","72_subLabel":"","72_hint":" ","72_description":"","72_readonly":"No","72_name":"input72","72_qid":72,"72_type":"control_textbox","72_order":9,"15_text":"Child 2","15_message":"","15_labelAlign":"Top","15_required":"No","15_prefix":"No","15_suffix":"No","15_middle":"Yes","15_description":"","15_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"15_readonly":"No","15_name":"child2","15_qid":15,"15_type":"control_fullname","15_order":10,"15_shrink":"Yes","68_text":"","68_message":"","68_labelAlign":"Auto","68_required":"No","68_size":20,"68_validation":"None","68_maxsize":"","68_inputTextMask":"","68_defaultValue":"","68_subLabel":"Hebrew Name","68_hint":" ","68_description":"","68_readonly":"No","68_name":"input68","68_qid":68,"68_type":"control_textbox","68_order":11,"28_text":"Birth Date","28_message":"","28_labelAlign":"Top","28_required":"No","28_format":"mmddyyyy","28_yearFrom":"","28_yearTo":"","28_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"28_description":"","28_sublabels":{"month":"Month","day":"Day","year":"Year"},"28_name":"birthDate28","28_qid":28,"28_type":"control_birthdate","28_order":12,"28_shrink":"Yes","20_text":"Gender","20_message":"","20_labelAlign":"Top","20_required":"No","20_options":"Male|Female","20_special":"None","20_allowOther":"No","20_otherText":"Other","20_calculateOther":"No","20_selected":"","20_spreadCols":"1","20_description":"","20_name":"gender20","20_qid":20,"20_type":"control_radio","20_order":13,"20_shrink":"Yes","73_text":"Child...","73_message":"","73_labelAlign":"Auto","73_required":"No","73_options":"\u0027s Natural Mother is Jewish|converted to Judaism|is adopted","73_special":"None","73_allowOther":"Yes","73_otherText":"Other","73_calculateOther":"No","73_selected":"","73_spreadCols":"3","73_description":"","73_name":"input73","73_qid":73,"73_type":"control_radio","73_order":14,"73_pricing":"0|0|0","74_text":"Child Reads Basic Hebrew?","74_message":"","74_labelAlign":"Auto","74_required":"No","74_options":"Yes|No","74_special":"None","74_allowOther":"No","74_otherText":"Other","74_calculateOther":"No","74_selected":"","74_spreadCols":"1","74_description":"","74_name":"input74","74_qid":74,"74_type":"control_radio","74_order":15,"75_text":"School Attending","75_message":"","75_labelAlign":"Auto","75_required":"No","75_size":20,"75_validation":"None","75_maxsize":"","75_inputTextMask":"","75_defaultValue":"","75_subLabel":"","75_hint":" ","75_description":"","75_readonly":"No","75_name":"input75","75_qid":75,"75_type":"control_textbox","75_order":16,"14_text":"Child 3","14_message":"","14_labelAlign":"Top","14_required":"No","14_prefix":"No","14_suffix":"No","14_middle":"Yes","14_description":"","14_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"14_readonly":"No","14_name":"child3","14_qid":14,"14_type":"control_fullname","14_order":17,"14_shrink":"Yes","71_text":"","71_message":"","71_labelAlign":"Auto","71_required":"No","71_size":20,"71_validation":"None","71_maxsize":"","71_inputTextMask":"","71_defaultValue":"","71_subLabel":"Hebrew Name","71_hint":" ","71_description":"","71_readonly":"No","71_name":"input71","71_qid":71,"71_type":"control_textbox","71_order":18,"29_text":"Birth Date","29_message":"","29_labelAlign":"Top","29_required":"No","29_format":"mmddyyyy","29_yearFrom":"","29_yearTo":"","29_months":[[],[],[],[],[],[],[],[],[],[],[],[]],"29_description":"","29_sublabels":{"month":"Month","day":"Day","year":"Year"},"29_name":"birthDate29","29_qid":29,"29_type":"control_birthdate","29_order":19,"29_shrink":"Yes","22_text":"Gender","22_message":"","22_labelAlign":"Top","22_required":"No","22_options":"Male|Female","22_special":"None","22_allowOther":"No","22_otherText":"Other","22_calculateOther":"No","22_selected":"","22_spreadCols":"1","22_description":"","22_name":"gender22","22_qid":22,"22_type":"control_radio","22_order":20,"22_shrink":"Yes","80_text":"Child...","80_message":"","80_labelAlign":"Auto","80_required":"No","80_options":"\u0027s Natural Mother is Jewish|converted to Judaism|is adopted","80_special":"None","80_allowOther":"Yes","80_otherText":"Other","80_calculateOther":"No","80_selected":"","80_spreadCols":"3","80_description":"","80_name":"input80","80_qid":80,"80_type":"control_radio","80_order":21,"80_pricing":"0|0|0","79_text":"Child Reads Basic Hebrew?","79_message":"","79_labelAlign":"Auto","79_required":"No","79_options":"Yes|No","79_special":"None","79_allowOther":"No","79_otherText":"Other","79_calculateOther":"No","79_selected":"","79_spreadCols":"1","79_description":"","79_name":"input79","79_qid":79,"79_type":"control_radio","79_order":22,"78_text":"School Attending","78_message":"","78_labelAlign":"Auto","78_required":"No","78_size":20,"78_validation":"None","78_maxsize":"","78_inputTextMask":"","78_defaultValue":"","78_subLabel":"","78_hint":" ","78_description":"","78_readonly":"No","78_name":"input78","78_qid":78,"78_type":"control_textbox","78_order":23,"60_text":"\u003cp\u003eIf you have additional children please contact us.\u003c/p\u003e","60_name":"doubleclickTo60","60_qid":60,"60_type":"control_text","60_order":24,"25_text":"2. Parent information","25_subHeader":"","25_headerType":"Default","25_name":"clickTo25","25_qid":25,"25_type":"control_head","25_order":25,"26_text":"Phone Number","26_message":"","26_labelAlign":"Auto","26_required":"Yes","26_validation":"Numeric","26_countryCode":"No","26_inputMask":"disable","26_inputMaskValue":"(###) ###-####","26_description":"","26_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"26_readonly":"No","26_name":"phoneNumber26","26_qid":26,"26_type":"control_phone","26_order":26,"24_text":"Address","24_message":"","24_labelAlign":"Auto","24_required":"Yes","24_selectedCountry":"","24_description":"","24_subfields":"st1|st2|city|state|zip|country","24_sublabels":{"cc_firstName":"First Name","cc_lastName":"Last Name","cc_number":"Credit Card Number","cc_ccv":"Security Code","cc_exp_month":"Expiration Month","cc_exp_year":"Expiration Year","addr_line1":"Street Address","addr_line2":"Street Address Line 2","city":"City","state":"State / Province","postal":"Postal / Zip Code","country":"Country"},"24_name":"address24","24_qid":24,"24_type":"control_address","24_order":27,"84_text":"We...","84_message":"","84_labelAlign":"Auto","84_required":"Yes","84_options":"Are Eligible for \"Hebrew School on Us\" and Can Provide Proof of Residency in Town of Oyster Bay.|Don\u0027t Reside in Town of Oyster Bay or Can\u0027t Provide Proof. Standard Tuition of $1200 Applies.","84_special":"None","84_allowOther":"No","84_otherText":"Other","84_calculateOther":"No","84_selected":"","84_spreadCols":"1","84_description":"","84_name":"input84","84_qid":84,"84_type":"control_radio","84_order":28,"84_pricing":"0|0","85_text":"\"Hebrew School on Us\" Agreement","85_message":"","85_labelAlign":"Auto","85_required":"Yes","85_options":"I understand that I\u0027m committing my child/ren to attending at least 90% of Hebrew School classes. If more than 20% of classes are missed, I will be responsible for full tuition.","85_special":"None","85_allowOther":"No","85_otherText":"Other","85_calculateOther":"No","85_spreadCols":"1","85_selected":"","85_minSelection":"","85_maxSelection":"","85_description":"","85_name":"input85","85_qid":85,"85_type":"control_checkbox","85_order":29,"23_text":"Mother\u0027s info","23_message":"","23_labelAlign":"Top","23_required":"No","23_prefix":"No","23_suffix":"No","23_middle":"No","23_description":"","23_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"23_readonly":"No","23_name":"mothersInfo","23_qid":23,"23_type":"control_fullname","23_order":30,"23_shrink":"Yes","4_receivesReceipts":"No","4_text":"E-mail","4_message":"Primary email","4_labelAlign":"Top","4_required":"No","4_size":30,"4_validation":"Email","4_maxsize":"","4_defaultValue":"","4_subLabel":"","4_hint":"ex: myname@example.com","4_description":"","4_confirmation":"No","4_confirmationHint":"Confirm Email","4_readonly":"No","4_name":"email4","4_qid":4,"4_type":"control_email","4_order":31,"4_shrink":"Yes","36_text":"Cell Phone","36_message":"","36_labelAlign":"Top","36_required":"No","36_validation":"Numeric","36_countryCode":"No","36_inputMask":"disable","36_inputMaskValue":"(###) ###-####","36_description":"","36_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"36_readonly":"No","36_name":"cellPhone36","36_qid":36,"36_type":"control_phone","36_order":32,"36_shrink":"Yes","81_text":"Child\u0027s Father and Mother are...","81_message":"","81_labelAlign":"Auto","81_required":"No","81_options":"Married|Divorced","81_special":"None","81_allowOther":"Yes","81_otherText":"Other","81_calculateOther":"No","81_selected":"","81_spreadCols":"3","81_description":"","81_name":"input81","81_qid":81,"81_type":"control_radio","81_order":33,"32_text":"Father\u0027s info","32_message":"","32_labelAlign":"Top","32_required":"No","32_prefix":"No","32_suffix":"No","32_middle":"No","32_description":"","32_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"32_readonly":"No","32_name":"fathersInfo","32_qid":32,"32_type":"control_fullname","32_order":34,"32_shrink":"Yes","35_receivesReceipts":"No","35_text":"E-mail","35_message":"","35_labelAlign":"Top","35_required":"No","35_size":30,"35_validation":"Email","35_maxsize":"","35_defaultValue":"","35_subLabel":"","35_hint":"ex: myname@example.com","35_description":"","35_confirmation":"No","35_confirmationHint":"Confirm Email","35_readonly":"No","35_name":"email35","35_qid":35,"35_type":"control_email","35_order":35,"35_shrink":"Yes","31_text":"Cell Phone","31_message":"","31_labelAlign":"Top","31_required":"No","31_validation":"Numeric","31_countryCode":"No","31_inputMask":"disable","31_inputMaskValue":"(###) ###-####","31_description":"","31_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"31_readonly":"No","31_name":"cellPhone","31_qid":31,"31_type":"control_phone","31_order":36,"31_shrink":"Yes","37_text":"3. Emergency Information","37_subHeader":"","37_headerType":"Default","37_name":"clickTo37","37_qid":37,"37_type":"control_head","37_order":37,"38_text":"Emergency Contact","38_message":"","38_labelAlign":"Top","38_required":"Yes","38_prefix":"No","38_suffix":"No","38_middle":"No","38_description":"","38_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"38_readonly":"No","38_name":"emergencyContact","38_qid":38,"38_type":"control_fullname","38_order":38,"38_shrink":"Yes","39_text":"Phone Number","39_message":"","39_labelAlign":"Top","39_required":"Yes","39_validation":"Numeric","39_countryCode":"No","39_inputMask":"disable","39_inputMaskValue":"(###) ###-####","39_description":"","39_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"39_readonly":"No","39_name":"phoneNumber39","39_qid":39,"39_type":"control_phone","39_order":39,"39_shrink":"Yes","40_text":"Relationship","40_message":"","40_labelAlign":"Auto","40_required":"Yes","40_size":20,"40_validation":"None","40_maxsize":"","40_inputTextMask":"","40_defaultValue":"","40_subLabel":"","40_hint":" ","40_description":"","40_readonly":"No","40_name":"relationship","40_qid":40,"40_type":"control_textbox","40_order":40,"41_text":"Pediatrician","41_message":"","41_labelAlign":"Top","41_required":"No","41_prefix":"No","41_suffix":"No","41_middle":"No","41_description":"","41_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"41_readonly":"No","41_name":"pediatricianamp","41_qid":41,"41_type":"control_fullname","41_order":41,"41_shrink":"Yes","42_text":"Phone Number","42_message":"","42_labelAlign":"Top","42_required":"No","42_validation":"Numeric","42_countryCode":"No","42_inputMask":"disable","42_inputMaskValue":"(###) ###-####","42_description":"","42_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"42_readonly":"No","42_name":"phoneNumber42","42_qid":42,"42_type":"control_phone","42_order":42,"42_shrink":"Yes","51_text":"Agreement","51_message":"","51_labelAlign":"Auto","51_required":"Yes","51_options":"I am signing up my child/ren for Hebrew School. I give my child/ren permission to attend all trips and receive medical care in the case of emergency, G-d forbid.   I give Aleph Champ Hebrew School permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the school sees fit. Refunds for children withdrawing from school before the end of the school year will be granted provided that the school office is given 30 days written notice. Tuition refunds will not be granted to children withdrawing from school after April 1st. A limited number of scholarships are available upon request; no child will be turned away for lack of funds.","51_special":"None","51_allowOther":"No","51_otherText":"Other","51_calculateOther":"No","51_spreadCols":"1","51_selected":"","51_minSelection":"","51_maxSelection":"","51_description":"","51_name":"agreement","51_qid":51,"51_type":"control_checkbox","51_order":43,"51_shrink":"No","66_text":"General comments","66_message":"","66_labelAlign":"Auto","66_required":"No","66_cols":"40","66_rows":6,"66_validation":"None","66_entryLimit":"None-0","66_maxsize":"","66_defaultValue":"","66_subLabel":"","66_hint":"","66_description":"","66_readonly":"No","66_wysiwyg":"Disable","66_name":"generalComments66","66_qid":66,"66_type":"control_textarea","66_order":44,"form_title":"I would like to Donate","form_pagetitle":"Form","form_styles":"nova","form_font":"","form_fontsize":"14","form_fontcolor":"","form_optioncolor":"","form_lineSpacing":"12","form_background":"","form_formWidth":"685","form_labelWidth":"150","form_alignment":"Left","form_thankurl":"","form_thanktext":"","form_highlightLine":"Enabled","form_activeRedirect":"default","form_sendpostdata":"No","form_unique":"None","form_uniqueField":"\u003cField Id\u003e","form_status":"Enabled","form_injectCSS":"","form_hideMailEmptyFields":"disable","form_showProgressBar":"disable","form_formStrings":[{"alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","confirmClearForm":"Are you sure you want to clear the form?","confirmEmail":"E-mail does not match","email":"Enter a valid e-mail address","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxSelectionsError":"The maximum number of selections allowed is","minSelectionsError":"The minimum required number of selections is","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","numeric":"This field can only contain numeric values","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","submissionLimit":"Sorry! Only one entry is allowed.  Multiple submissions are disabled for this form.","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:"}],"form_limitSubmission":"No Limit","form_expireDate":"No Limit","form_messageOfLimitedForm":"This form is currently unavailable!","form_emails":[],"form_language":"","form_sendEmail":"Yes","form_style":"Default","form_theme":"nova","form_id":4077963,"form_formStringsChanged":"yes","form_slug":4077963,"form_stopHighlight":"Yes","form_optinDisabled":"true","form_conditions":[{"type":"field","link":"Any","terms":[{"field":"84","operator":"equals","value":"Are \"Eligible for \"Hebrew School on Us\" and Can Provide Proof of Residency in Town of Oyster Bay."}],"actions":[{"field":"85","visibility":"Show"}]}],"86_name":"submit","86_type":"control_button","86_qid":86,"86_order":45,"86_text":"Submit","86_buttonAlign":"Auto","86_clear":"No","86_print":"No"}][0] || {}, window.formJson || {});
window.isSecureForm = true
});

			if (typeof(Userform) ==='undefined')
			{
				Userform={init:function(args){
					$j(function(){
						Userform.init.apply(Userform, [args]);
					})
				},
				setConditions:function(args){
					$j(function(){
						Userform.setConditions.apply(Userform, [args]);
					})
				}};
			}
</script><script type="text/javascript">
   Userform.setConditions([{"type":"field","link":"Any","terms":[{"field":"84","operator":"equals","value":"Are \"Eligible for \"Hebrew School on Us\" and Can Provide Proof of Residency in Town of Oyster Bay."}],"actions":[{"field":"85","visibility":"Show"}]}]);
   Userform.init(function(){
      $('input_4').hint('ex: myname@example.com');
      $('input_35').hint('ex: myname@example.com');
      Userform.alterTexts({"alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","confirmClearForm":"Are you sure you want to clear the form?","confirmEmail":"E-mail does not match","email":"Enter a valid e-mail address","generalError":"There are errors on the form. Please fix them before continuing.","generalPageError":"There are errors on this page. Please fix them before continuing.","gradingScoreError":"Score total should only be less than or equal to","incompleteFields":"There are incomplete required fields. Please complete them.","inputCarretErrorA":"Input should not be less than the minimum value:","inputCarretErrorB":"Input should not be greater than the maximum value:","lessThan":"Your score should be less than or equal to","maxDigitsError":"The maximum digits allowed is","maxSelectionsError":"The maximum number of selections allowed is","minSelectionsError":"The minimum required number of selections is","multipleFileUploads_emptyError":"{file} is empty, please select files again without it.","multipleFileUploads_minSizeError":"{file} is too small, minimum file size is {minSizeLimit}.","multipleFileUploads_onLeave":"The files are being uploaded, if you leave now the upload will be cancelled.","multipleFileUploads_sizeError":"{file} is too large, maximum file size is {sizeLimit}.","multipleFileUploads_typeError":"{file} has invalid extension. Only {extensions} are allowed.","numeric":"This field can only contain numeric values","pastDatesDisallowed":"Date must not be in the past.","pleaseWait":"Please wait...","required":"This field is required.","requireEveryRow":"Every row is required.","requireOne":"At least one field required.","submissionLimit":"Sorry! Only one entry is allowed.  Multiple submissions are disabled for this form.","uploadExtensions":"You can only upload following files:","uploadFilesize":"File size cannot be bigger than:"});
   });
</script>
<style type="text/css" id="GenFormStyles">
    .form-label{
        width:150px !important;
    }
    .form-label-left{
        width:150px !important;
    }
    .form-line{
        padding-top:12px;
        padding-bottom:12px;
    }
    .form-label-right{
        width:150px !important;
    }
    .form-all {
        font-size:14px;
    }
.co_body .content .form-all p {
 font-size:14px;

}
@media screen and (max-width: 600px) {.form-label-left{	float:none;	display:block;}.form-buttons-wrapper.button-align-auto{text-indent: 0!important;}}</style>

<form class="userform-form" action="" method="post" name="form_4077963" id="4077963" accept-charset="utf-8"><input type="hidden" name="formID" value="4077963" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li class="form-line" id="id_64"><div id="cid_64" class="form-input-wide"> <div id="text_64" class="form-html"><p><strong>Enroll your child in the Hebrew School where kids don't want to miss a day!</strong></p><p>At Aleph Champ Hebrew School we try to keep the admissions process as simple as possible. We also offer several opportunities to get to know the school, before you apply. Please contact us for more information. <br /><br />Complete the form below. If you have any questions, we'll be happy to help!</p><p>Rabbi Shalom Lipszyc - 347 853 9992</p><p><span style="font-size: 12px;"><em>Due to limited space and a high number of applicants each year, we are unfortunately unable to accept every child for admission. Applications are processed in the order they are received.</em></span></p></div> </div></li><li id="cid_9" class="form-input-wide"> <div class="form-header-group"><h2 id="header_9" class="form-header">1. Child/ren’s Information</h2></div> </li><li class="form-line" id="id_3"><div class="form-label-left" id="label_3"><label for="input_3"> Child 1<span class="form-required">*</span> </label><label class="label-message" for="input_3"> </label></div><div id="cid_3" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q3_child1[first]" id="first_3" autocomplete="given-name" />  <label class="form-sub-label" for="first_3" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q3_child1[middle]" id="middle_3" autocomplete="additional-name" />  <label class="form-sub-label" for="middle_3" id="sublabel_middle">Middle Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q3_child1[last]" id="last_3" autocomplete="family-name" />  <label class="form-sub-label" for="last_3" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_67"><div class="form-label-left" id="label_67"><label for="input_67">  </label><label class="label-message" for="input_67"> </label></div><div id="cid_67" class="form-input"> <span class="form-sub-label-container"><input type="text" class=" form-textbox" data-type="input-textbox" id="input_67" name="q67_input67" size="20" value="" />  <label class="form-sub-label" for="input_67">Hebrew Name</label></span> </div></li><li class="form-line" id="id_27"><div class="form-label-left" id="label_27"><label for="input_27"> Birth Date<span class="form-required">*</span> </label><label class="label-message" for="input_27"> </label></div><div id="cid_27" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q27_birthDate27[month]" id="input_27_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_27_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q27_birthDate27[day]" id="input_27_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_27_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q27_birthDate27[year]" id="input_27_year"><option></option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_27_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_19"><div class="form-label-left" id="label_19"><label for="input_19"> Gender<span class="form-required">*</span> </label><label class="label-message" for="input_19"> </label></div><div id="cid_19" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_19_0" name="q19_gender" value="Male" /><label id="label_input_19_0" for="input_19_0"><span>Male</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_19_1" name="q19_gender" value="Female" /><label id="label_input_19_1" for="input_19_1"><span>Female</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_77"><div class="form-label-left" id="label_77"><label for="input_77"> Child...<span class="form-required">*</span> </label><label class="label-message" for="input_77"> </label></div><div id="cid_77" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_77_0" name="q77_input77" value="'s Natural Mother is Jewish" /><label id="label_input_77_0" for="input_77_0"><span>'s Natural Mother is Jewish</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_77_1" name="q77_input77" value="converted to Judaism" /><label id="label_input_77_1" for="input_77_1"><span>converted to Judaism</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio validate[required]" id="input_77_2" name="q77_input77" value="is adopted" /><label id="label_input_77_2" for="input_77_2"><span>is adopted</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[required, other]" name="q77_input77" id="other_77" value="" /><span><input type="text" form-radio="" class="form-radio-other-input form-textbox " name="q77_input77[other]" data-otherhint="Other" size="15" id="input_77" disabled="disabled" /></span><br /></span></div> </div></li><li class="form-line" id="id_76"><div class="form-label-left" id="label_76"><label for="input_76"> Child Reads Basic Hebrew?<span class="form-required">*</span> </label><label class="label-message" for="input_76"> </label></div><div id="cid_76" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_76_0" name="q76_input76" value="Yes" /><label id="label_input_76_0" for="input_76_0"><span>Yes</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_76_1" name="q76_input76" value="No" /><label id="label_input_76_1" for="input_76_1"><span>No</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_72"><div class="form-label-left" id="label_72"><label for="input_72"> School Attending<span class="form-required">*</span> </label><label class="label-message" for="input_72"> </label></div><div id="cid_72" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_72" name="q72_input72" size="20" value="" /> </div></li><li class="form-line" id="id_15"><div class="form-label-left" id="label_15"><label for="input_15"> Child 2 </label><label class="label-message" for="input_15"> </label></div><div id="cid_15" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q15_child2[first]" id="first_15" autocomplete="given-name" />  <label class="form-sub-label" for="first_15" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q15_child2[middle]" id="middle_15" autocomplete="additional-name" />  <label class="form-sub-label" for="middle_15" id="sublabel_middle">Middle Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="15" name="q15_child2[last]" id="last_15" autocomplete="family-name" />  <label class="form-sub-label" for="last_15" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_68"><div class="form-label-left" id="label_68"><label for="input_68">  </label><label class="label-message" for="input_68"> </label></div><div id="cid_68" class="form-input"> <span class="form-sub-label-container"><input type="text" class=" form-textbox" data-type="input-textbox" id="input_68" name="q68_input68" size="20" value="" />  <label class="form-sub-label" for="input_68">Hebrew Name</label></span> </div></li><li class="form-line" id="id_28"><div class="form-label-left" id="label_28"><label for="input_28"> Birth Date </label><label class="label-message" for="input_28"> </label></div><div id="cid_28" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select class="form-dropdown" name="q28_birthDate28[month]" id="input_28_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_28_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select class="form-dropdown" name="q28_birthDate28[day]" id="input_28_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_28_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select class="form-dropdown" name="q28_birthDate28[year]" id="input_28_year"><option></option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_28_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_20"><div class="form-label-left" id="label_20"><label for="input_20"> Gender </label><label class="label-message" for="input_20"> </label></div><div id="cid_20" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_20_0" name="q20_gender20" value="Male" /><label id="label_input_20_0" for="input_20_0"><span>Male</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_20_1" name="q20_gender20" value="Female" /><label id="label_input_20_1" for="input_20_1"><span>Female</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_73"><div class="form-label-left" id="label_73"><label for="input_73"> Child... </label><label class="label-message" for="input_73"> </label></div><div id="cid_73" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio" id="input_73_0" name="q73_input73" value="'s Natural Mother is Jewish" /><label id="label_input_73_0" for="input_73_0"><span>'s Natural Mother is Jewish</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_73_1" name="q73_input73" value="converted to Judaism" /><label id="label_input_73_1" for="input_73_1"><span>converted to Judaism</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_73_2" name="q73_input73" value="is adopted" /><label id="label_input_73_2" for="input_73_2"><span>is adopted</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[other]" name="q73_input73" id="other_73" value="" /><span><input type="text" form-radio="" class="form-radio-other-input form-textbox " name="q73_input73[other]" data-otherhint="Other" size="15" id="input_73" disabled="disabled" /></span><br /></span></div> </div></li><li class="form-line" id="id_74"><div class="form-label-left" id="label_74"><label for="input_74"> Child Reads Basic Hebrew? </label><label class="label-message" for="input_74"> </label></div><div id="cid_74" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_74_0" name="q74_input74" value="Yes" /><label id="label_input_74_0" for="input_74_0"><span>Yes</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_74_1" name="q74_input74" value="No" /><label id="label_input_74_1" for="input_74_1"><span>No</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_75"><div class="form-label-left" id="label_75"><label for="input_75"> School Attending </label><label class="label-message" for="input_75"> </label></div><div id="cid_75" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_75" name="q75_input75" size="20" value="" /> </div></li><li class="form-line" id="id_14"><div class="form-label-left" id="label_14"><label for="input_14"> Child 3 </label><label class="label-message" for="input_14"> </label></div><div id="cid_14" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q14_child3[first]" id="first_14" autocomplete="given-name" />  <label class="form-sub-label" for="first_14" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q14_child3[middle]" id="middle_14" autocomplete="additional-name" />  <label class="form-sub-label" for="middle_14" id="sublabel_middle">Middle Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="15" name="q14_child3[last]" id="last_14" autocomplete="family-name" />  <label class="form-sub-label" for="last_14" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_71"><div class="form-label-left" id="label_71"><label for="input_71">  </label><label class="label-message" for="input_71"> </label></div><div id="cid_71" class="form-input"> <span class="form-sub-label-container"><input type="text" class=" form-textbox" data-type="input-textbox" id="input_71" name="q71_input71" size="20" value="" />  <label class="form-sub-label" for="input_71">Hebrew Name</label></span> </div></li><li class="form-line" id="id_29"><div class="form-label-left" id="label_29"><label for="input_29"> Birth Date </label><label class="label-message" for="input_29"> </label></div><div id="cid_29" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><select class="form-dropdown" name="q29_birthDate29[month]" id="input_29_month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_29_month" id="sublabel_month">Month</label></span><span class="form-sub-label-container"><select class="form-dropdown" name="q29_birthDate29[day]" id="input_29_day"><option></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select>  <label class="form-sub-label" for="input_29_day" id="sublabel_day">Day</label></span><span class="form-sub-label-container"><select class="form-dropdown" name="q29_birthDate29[year]" id="input_29_year"><option></option><option value="2025">2025</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option></select>  <label class="form-sub-label" for="input_29_year" id="sublabel_year">Year</label></span></div> </div></li><li class="form-line" id="id_22"><div class="form-label-left" id="label_22"><label for="input_22"> Gender </label><label class="label-message" for="input_22"> </label></div><div id="cid_22" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_22_0" name="q22_gender22" value="Male" /><label id="label_input_22_0" for="input_22_0"><span>Male</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_22_1" name="q22_gender22" value="Female" /><label id="label_input_22_1" for="input_22_1"><span>Female</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_80"><div class="form-label-left" id="label_80"><label for="input_80"> Child... </label><label class="label-message" for="input_80"> </label></div><div id="cid_80" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio" id="input_80_0" name="q80_input80" value="'s Natural Mother is Jewish" /><label id="label_input_80_0" for="input_80_0"><span>'s Natural Mother is Jewish</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_80_1" name="q80_input80" value="converted to Judaism" /><label id="label_input_80_1" for="input_80_1"><span>converted to Judaism</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_80_2" name="q80_input80" value="is adopted" /><label id="label_input_80_2" for="input_80_2"><span>is adopted</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[other]" name="q80_input80" id="other_80" value="" /><span><input type="text" form-radio="" class="form-radio-other-input form-textbox " name="q80_input80[other]" data-otherhint="Other" size="15" id="input_80" disabled="disabled" /></span><br /></span></div> </div></li><li class="form-line" id="id_79"><div class="form-label-left" id="label_79"><label for="input_79"> Child Reads Basic Hebrew? </label><label class="label-message" for="input_79"> </label></div><div id="cid_79" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_79_0" name="q79_input79" value="Yes" /><label id="label_input_79_0" for="input_79_0"><span>Yes</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_79_1" name="q79_input79" value="No" /><label id="label_input_79_1" for="input_79_1"><span>No</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_78"><div class="form-label-left" id="label_78"><label for="input_78"> School Attending </label><label class="label-message" for="input_78"> </label></div><div id="cid_78" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_78" name="q78_input78" size="20" value="" /> </div></li><li class="form-line" id="id_60"><div id="cid_60" class="form-input-wide"> <div id="text_60" class="form-html"><p>If you have additional children please contact us.</p></div> </div></li><li id="cid_25" class="form-input-wide"> <div class="form-header-group"><h2 id="header_25" class="form-header">2. Parent information</h2></div> </li><li class="form-line" id="id_26"><div class="form-label-left" id="label_26"><label for="input_26"> Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_26"> </label></div><div id="cid_26" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q26_phoneNumber26[area]" id="input_26_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_26_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q26_phoneNumber26[phone]" id="input_26_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_26_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_24"><div class="form-label-left" id="label_24"><label for="input_24"> Address<span class="form-required">*</span> </label><label class="label-message" for="input_24"> </label></div><div id="cid_24" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q24_address24[addr_line1]" id="input_24_addr_line1" size="46" autocomplete="address-line1" />  <label class="form-sub-label" for="input_24_addr_line1" id="sublabel_24_addr_line1">Street Address</label></span></td></tr><tr><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line no-validation" type="text" name="q24_address24[addr_line2]" id="input_24_addr_line2" size="46" autocomplete="address-line2" />  <label class="form-sub-label" for="input_24_addr_line2" id="sublabel_24_addr_line2">Street Address Line 2</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q24_address24[city]" id="input_24_city" size="21" autocomplete="address-level2" />  <label class="form-sub-label" for="input_24_city" id="sublabel_24_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q24_address24[state]" id="input_24_state" size="22" autocomplete="address-level1" />  <label class="form-sub-label" for="input_24_state" id="sublabel_24_state">State / Province</label></span></td></tr><tr><td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q24_address24[postal]" id="input_24_postal" size="10" autocomplete="postal-code" />  <label class="form-sub-label" for="input_24_postal" id="sublabel_24_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q24_address24[country]" id="input_24_country" autocomplete="country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="People's Republic of China">People's Republic of China</option><option value="Republic of China">Republic of China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote d'Ivoire">Cote d'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Eswatini">Eswatini</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="The Gambia">The Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="North Korea">North Korea</option><option value="South Korea">South Korea</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana">Northern Mariana</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Barthelemy">Saint Barthelemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="Somaliland">Somaliland</option><option value="South Africa">South Africa</option><option value="South Ossetia">South Ossetia</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard">Svalbard</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Timor-Leste">Timor-Leste</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="British Virgin Islands">British Virgin Islands</option><option value="US Virgin Islands">US Virgin Islands</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="other">Other</option></select>  <label class="form-sub-label" for="input_24_country" id="sublabel_24_country">Country</label></span></td></tr></tbody></table> </div></li><li class="form-line" id="id_84"><div class="form-label-left" id="label_84"><label for="input_84"> We...<span class="form-required">*</span> </label><label class="label-message" for="input_84"> </label></div><div id="cid_84" class="form-input"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_84_0" name="q84_input84" value="Are Eligible for &quot;Hebrew School on Us&quot; and Can Provide Proof of Residency in Town of Oyster Bay." /><label id="label_input_84_0" for="input_84_0"><span>Are Eligible for "Hebrew School on Us" and Can Provide Proof of Residency in Town of Oyster Bay.</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_84_1" name="q84_input84" value="Don't Reside in Town of Oyster Bay or Can't Provide Proof. Standard Tuition of $1200 Applies." /><label id="label_input_84_1" for="input_84_1"><span>Don't Reside in Town of Oyster Bay or Can't Provide Proof. Standard Tuition of $1200 Applies.</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_85"><div class="form-label-left" id="label_85"><label for="input_85"> "Hebrew School on Us" Agreement<span class="form-required">*</span> </label><label class="label-message" for="input_85"> </label></div><div id="cid_85" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_85_0" name="q85_input85[]" value="I understand that I'm committing my child/ren to attending at least 90% of Hebrew School classes. If more than 20% of classes are missed, I will be responsible for full tuition." /><label id="label_input_85_0" for="input_85_0"><span>I understand that I'm committing my child/ren to attending at least 90% of Hebrew School classes. If more than 20% of classes are missed, I will be responsible for full tuition.</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_23"><div class="form-label-left" id="label_23"><label for="input_23"> Mother's info </label><label class="label-message" for="input_23"> </label></div><div id="cid_23" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q23_mothersInfo[first]" id="first_23" autocomplete="given-name" />  <label class="form-sub-label" for="first_23" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="15" name="q23_mothersInfo[last]" id="last_23" autocomplete="family-name" />  <label class="form-sub-label" for="last_23" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_4"><div class="form-label-left" id="label_4"><label for="input_4"> E-mail </label><label class="label-message" for="input_4"> Primary email</label></div><div id="cid_4" class="form-input"> <input type="email" class=" form-textbox validate[Email]" id="input_4" name="q4_email4" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_36"><div class="form-label-left" id="label_36"><label for="input_36"> Cell Phone </label><label class="label-message" for="input_36"> </label></div><div id="cid_36" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q36_cellPhone36[area]" id="input_36_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_36_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q36_cellPhone36[phone]" id="input_36_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_36_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_81"><div class="form-label-left" id="label_81"><label for="input_81"> Child's Father and Mother are... </label><label class="label-message" for="input_81"> </label></div><div id="cid_81" class="form-input"> <div class="form-multiple-column"><span class="form-radio-item"><input type="radio" class="form-radio" id="input_81_0" name="q81_input81" value="Married" /><label id="label_input_81_0" for="input_81_0"><span>Married</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_81_1" name="q81_input81" value="Divorced" /><label id="label_input_81_1" for="input_81_1"><span>Divorced</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio validate[other]" name="q81_input81" id="other_81" value="" /><span><input type="text" form-radio="" class="form-radio-other-input form-textbox " name="q81_input81[other]" data-otherhint="Other" size="15" id="input_81" disabled="disabled" /></span><br /></span></div> </div></li><li class="form-line" id="id_32"><div class="form-label-left" id="label_32"><label for="input_32"> Father's info </label><label class="label-message" for="input_32"> </label></div><div id="cid_32" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q32_fathersInfo[first]" id="first_32" autocomplete="given-name" />  <label class="form-sub-label" for="first_32" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="15" name="q32_fathersInfo[last]" id="last_32" autocomplete="family-name" />  <label class="form-sub-label" for="last_32" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_35"><div class="form-label-left" id="label_35"><label for="input_35"> E-mail </label><label class="label-message" for="input_35"> </label></div><div id="cid_35" class="form-input"> <input type="email" class=" form-textbox validate[Email]" id="input_35" name="q35_email35" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_31"><div class="form-label-left" id="label_31"><label for="input_31"> Cell Phone </label><label class="label-message" for="input_31"> </label></div><div id="cid_31" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q31_cellPhone[area]" id="input_31_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_31_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q31_cellPhone[phone]" id="input_31_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_31_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li id="cid_37" class="form-input-wide"> <div class="form-header-group"><h2 id="header_37" class="form-header">3. Emergency Information</h2></div> </li><li class="form-line" id="id_38"><div class="form-label-left" id="label_38"><label for="input_38"> Emergency Contact<span class="form-required">*</span> </label><label class="label-message" for="input_38"> </label></div><div id="cid_38" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q38_emergencyContact[first]" id="first_38" autocomplete="given-name" />  <label class="form-sub-label" for="first_38" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q38_emergencyContact[last]" id="last_38" autocomplete="family-name" />  <label class="form-sub-label" for="last_38" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_39"><div class="form-label-left" id="label_39"><label for="input_39"> Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_39"> </label></div><div id="cid_39" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q39_phoneNumber39[area]" id="input_39_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_39_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q39_phoneNumber39[phone]" id="input_39_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_39_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_40"><div class="form-label-left" id="label_40"><label for="input_40"> Relationship<span class="form-required">*</span> </label><label class="label-message" for="input_40"> </label></div><div id="cid_40" class="form-input"> <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_40" name="q40_relationship" size="20" value="" /> </div></li><li class="form-line" id="id_41"><div class="form-label-left" id="label_41"><label for="input_41"> Pediatrician </label><label class="label-message" for="input_41"> </label></div><div id="cid_41" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox" type="text" size="10" name="q41_pediatricianamp[first]" id="first_41" autocomplete="given-name" />  <label class="form-sub-label" for="first_41" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox" type="text" size="15" name="q41_pediatricianamp[last]" id="last_41" autocomplete="family-name" />  <label class="form-sub-label" for="last_41" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_42"><div class="form-label-left" id="label_42"><label for="input_42"> Phone Number </label><label class="label-message" for="input_42"> </label></div><div id="cid_42" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q42_phoneNumber42[area]" id="input_42_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_42_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[Numeric]" type="tel" name="q42_phoneNumber42[phone]" id="input_42_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_42_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_51"><div class="form-label-left" id="label_51"><label for="input_51"> Agreement<span class="form-required">*</span> </label><label class="label-message" for="input_51"> </label></div><div id="cid_51" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_51_0" name="q51_agreement[]" value="I am signing up my child/ren for Hebrew School. I give my child/ren permission to attend all trips and receive medical care in the case of emergency, G-d forbid.   I give Aleph Champ Hebrew School permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the school sees fit. Refunds for children withdrawing from school before the end of the school year will be granted provided that the school office is given 30 days written notice. Tuition refunds will not be granted to children withdrawing from school after April 1st. A limited number of scholarships are available upon request; no child will be turned away for lack of funds." /><label id="label_input_51_0" for="input_51_0"><span>I am signing up my child/ren for Hebrew School. I give my child/ren permission to attend all trips and receive medical care in the case of emergency, G-d forbid.   I give Aleph Champ Hebrew School permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the school sees fit. Refunds for children withdrawing from school before the end of the school year will be granted provided that the school office is given 30 days written notice. Tuition refunds will not be granted to children withdrawing from school after April 1st. A limited number of scholarships are available upon request; no child will be turned away for lack of funds.</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_66"><div class="form-label-left" id="label_66"><label for="input_66"> General comments </label><label class="label-message" for="input_66"> </label></div><div id="cid_66" class="form-input"> <textarea id="input_66" class="form-textarea" name="q66_generalComments66" cols="40" rows="6"></textarea> </div></li><li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li><li class="form-line" id="id_86"><div id="cid_86" class="form-input-wide"><div style="text-align:center" class="form-buttons-wrapper"><button id="input_86" type="submit" class="form-submit-button form-submit-button-none;">Submit</button></div></div></li></ul></div><input type="hidden" id="simple_spc" name="simple_spc" value="4077963" /><script type="text/javascript">document.getElementById("si"+"mple"+"_spc").value = "4077963-4077963";</script></form></div>
<div class="center small">
	<img valign="absbottom" src="https://w2.chabad.org/images/global/icons/lock.gif" width="16" height="16" alt="Secure"> This page uses TLS encryption to keep your data secure.
</div>
	<div class="break_floats"></div>
	

<div class="content-footer">
	
	
	
	
	
	
</div>
	</article>

		</div>
	</div>
</div>
						
						<div class="break_floats"></div>
						
					</div>
				</div>
				
				
				
			</div>
			
			<!-- BEGIN FOOTER --></div></div>
&#160;

<div class="ct-footer-illustrations">
<img src="https://w2.chabad.org/media/images/1040/GdjY10403190.png" class="ct-footer-illustration-hill-left" />
<img src="https://w2.chabad.org/media/images/1040/Zsxf10403210.png" class="ct-footer-illustration-swim" />
<img src="https://w2.chabad.org/media/images/1040/FqYG10403192.png" class="ct-footer-illustration-hill-right" />
<img src="https://w2.chabad.org/media/images/1040/qFtQ10403208.png" class="ct-footer-illustration-soccer-boy" data-stellar-ratio="1.95" />
<img src="https://w2.chabad.org/media/images/1040/Fodo10403178.png" class="ct-footer-illustration-bottom-grass" />
<img src="https://w2.chabad.org/media/images/1040/tFcQ10403188.png" class="ct-footer-illustration-grass-small" />
<img src="https://w2.chabad.org/media/images/1040/dYne10403180.png" class="ct-footer-illustration-carousel" />
<img src="https://w2.chabad.org/media/images/1040/sZof10403206.png" class="ct-footer-illustration-shabbat" />
<img src="https://w2.chabad.org/media/images/1040/DKKC10403202.png" class="ct-footer-illustration-rock-small" />
<img src="https://w2.chabad.org/media/images/1040/Qnlt10403200.png" class="ct-footer-illustration-rock-large" />
<img src="https://w2.chabad.org/media/images/1040/sirj10403212.png" class="ct-footer-illustration-tennis-girl" data-stellar-ratio="0.99" />
<img src="https://w2.chabad.org/media/images/1040/tFcQ10403188.png" class="ct-footer-illustration-grass-small" />
</div>
</div>

</div></div>

<co:protected>
<script>(function(d, s, id) {
      var js, fjs = d.getElementsByTagName(s)[0];
      if (d.getElementById(id)) return;
      js = d.createElement(s); js.id = id;
      js.src = 'https://connect.facebook.net/en_US/sdk.js#xfbml=1&version=v2.10&appId=1699705643642334';
      fjs.parentNode.insertBefore(js, fjs);
    }(document, 'script', 'facebook-jssdk'));</script><!-- END FOOTER -->
		</div>
		
		<aside class="page-tools-sidebar js-page-tools-sidebar hide_for_print">
<div class="page-tools js-page-tools-menu">
<div class="page-tools__section page-tools__section--share">
<a class="page-tools__tool js-share-popup page-tools__tool--facebook" data-share-url="https://www.facebook.com/dialog/share?app_id=188669250943&amp;display=popup&amp;href=https%3a%2f%2fwww.jewishtob.org%2ftemplates%2farticlecco_cdo%2faid%2f4077963%2fjewish%2fRegister-Online.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dFB">
				<i class="fa fa-facebook"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--twitter" data-share-url="https://twitter.com/intent/tweet?text=Register+Online+-+Town+of+Oyster+Bay+Chabad+-+Center+for+Jewish+Life+Long+Island+&amp;url=https%3a%2f%2fwww.jewishtob.org%2ftemplates%2farticlecco_cdo%2faid%2f4077963%2fjewish%2fRegister-Online.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dtwitter&amp;via=Chabad">
				<i class="fa fa-twitter"></i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--whatsapp d-lg-none js-share-whatsapp" data-share-url="whatsapp://send?text=Register+Online+-+Town+of+Oyster+Bay+Chabad+-+Center+for+Jewish+Life+Long+Island+ https%3a%2f%2fwww.jewishtob.org%2ftemplates%2farticlecco_cdo%2faid%2f4077963%2fjewish%2fRegister-Online.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dwhatsapp">
				<i class="fa fa-whatsapp">
					<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 50 50" fill="#128c7e" width="1em" height="1em"><path d="M25 2C12.318 2 2 12.318 2 25c0 3.96 1.023 7.854 2.963 11.29L2.037 46.73c-.096.343-.003.711.245.966.191.197.451.304.718.304.08 0 .161-.01.24-.029l10.896-2.699C17.463 47.058 21.21 48 25 48c12.682 0 23-10.318 23-23S37.682 2 25 2zm11.57 31.116c-.492 1.362-2.852 2.605-3.986 2.772-1.018.149-2.306.213-3.72-.231-.857-.27-1.957-.628-3.366-1.229-5.923-2.526-9.791-8.415-10.087-8.804-.295-.389-2.411-3.161-2.411-6.03s1.525-4.28 2.067-4.864c.542-.584 1.181-.73 1.575-.73s.787.005 1.132.021c.363.018.85-.137 1.329 1.001.492 1.168 1.673 4.037 1.819 4.33.148.292.246.633.05 1.022s-.294.632-.59.973-.62.76-.886 1.022c-.296.291-.603.606-.259 1.19s1.529 2.493 3.285 4.039c2.255 1.986 4.158 2.602 4.748 2.894.59.292.935.243 1.279-.146.344-.39 1.476-1.703 1.869-2.286s.787-.487 1.329-.292c.542.194 3.445 1.604 4.035 1.896.59.292.984.438 1.132.681.148.242.148 1.41-.344 2.771z"/></svg>
				</i>
			</a>
<a class="page-tools__tool js-share-popup page-tools__tool--pinterest d-none d-lg-block" data-share-url="http://pinterest.com/pin/create/button/?url=https%3a%2f%2fwww.jewishtob.org%2ftemplates%2farticlecco_cdo%2faid%2f4077963%2fjewish%2fRegister-Online.htm%23utm_medium%3dpage_tools%26utm_content%3ddesktop%26utm_source%3dpinterest&amp;description=Register+Online+-+Town+of+Oyster+Bay+Chabad+-+Center+for+Jewish+Life+Long+Island+">
				<i class="fa fa-pinterest"></i>
			</a>
<a class="page-tools__tool" onclick="showEmailLayer(this);">
<i class="fa fa-envelope"></i>
</a>
</div>
<div class="page-tools__section page-tools__section--other js-page-tool-other">
<div class="page-tools__tool popover-parent d-lg-block">
<div class="popover popover--right align_left nowrap">
<div class="popover__content">
<label class="bold bottom_margin block">
Print Options:
</label>
<form class="vcenter" name="print-form" onsubmit="coPrint(event, 3913106);return false;">
<div>
<label><input type="checkbox" name="print-green"><span title="Save paper and ink">Print without images <i class="fa fa-leaf text-green"></i></span></label>
</div>
<br/>
<div class="center">
<button class="co-button page-tools__print-button">Print</button>
</div>
</form>
</div>
</div>
<i class="fa fa-print"></i>
</div>
</div>
</div>
<div class="js-fab-wrapper fab-wrapper">
<div class="fab">
<i class="fab-icon"></i>
</div>
</div>
</aside>
<!-- END CACHE -->
	</div>

	</div>

	<div id="BodyContainer">
		<div class="g960 footer">
			<div class="poweredby large_bottom_margin">
				


	<div class="footer3"><b>Town of Oyster Bay Chabad - Center for Jewish Life in Long Island.   |   678 Woodbury Rd. Woodbury, NY. 11797    |    jewishtob.org</b></div>
	<img src="https://w2.chabad.org/images/global/spacer.gif" width="1" height="6" border="0" /><br />




Powered by <a href="https://www.chabad.org/" target="_new" class="">Chabad.org</a> &copy; 1993-2026 <a href="/4026210" target="_blank" class="privacy-link">Privacy Policy</a>




			</div>
		</div>
	</div>
	
	

	
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery-latest.min.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/os/jquery/jquery.inputmask.min.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/co/dist/CoLib.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/WebComponents/bundles/magen-cdo-global.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/modules/pagetools.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/multimedia/infolayer.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/forms/userform.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/commentsloader.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/minisites.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/subscribeprompt.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/templates/FormDecoder.js"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/custom/deprecated.js?v=4.1.3"></script>
<script type="text/javascript" src="https://w2.chabad.org/scripts/js/OverrideJSDocumentWrite.js"></script><script>$j = $j.fn ? $j : jQuery;$j(()=>{$q.forEach(f=>{try{f.call(window);}catch(ex){console.error(ex);}});})</script>
	

<script  language="javascript" type="text/javascript"> Co.Settings      = {CacheClassName:'js-cache-default',MosadName:'Town of Oyster Bay Chabad - Center for Jewish Life Long Island '}; Co.ArticleId     = '4077963';Co.SectionId     = 3913106;Co.PartnerSiteId = 0;Co.SiteId        = 162;Co.IsMobilePage  = false;Co.IsResponsive  = false;Co.DbDomain      = 'JewishTOB.org';Co.LanguageCode  = '';Co.LoginStatus   = 'None';</script>
	
	

</body>
</html>