Munchkin Minyan 1st Time Non-Member Family Registration - Form

Munchkin Minyan North Saturday programs are geared to children 7 years and younger. First time non-member families are FREE! $10/per family for each session after the first one.

* Please choose the number of children enrolling

* Child's First Name

* Child's Last Name

* Child's Date of Birth (MM/DD/YYYY)

* Temple Shalom Member?

Please Select OneYesNo

Please choose the number of adults attending

* Adult Attending First Name

* Adult Attending Last Name

* Email Address

* Mobile

* Relationship to Child

* Temple Shalom member?

Please Select OneYESNO

* Confirmation Email

* Mobile of Person completing form

* Street Address

* City

* State

* Zip Code

* Please tell us how you heard of this program.

* Photo Release--I consent to the use of images of anyone in our party as described below.

Please Select OneYESNOPrivacy and Use of Images: Families may be photographed or videotaped as they participate in Temple activities, or they may be recorded in Temple Shalom video stream programs. On occasion, these images, and the identity of the persons depicted, may be used by Temple Shalom for educational, instructional, development and/or informational purposes in print, internet and digital media, including in news releases (e.g, Texas Jewish Post) and/or printed publications or materials, electronic publications, or websites. Temple Shalom will not sell images of Temple Shalom members or non-members or their families to third parties, and it will not use their images for promotional or advertising purposes that do not concern Temple Shalom and its programs.