Munchkin Minyan Registration - Form

Thank you for registering for our Munchkin Minyan program. There is no cost for Temple Shalom families.

There is a Munchkin Minyan program fee of $10/family per session for non-members after the first time.

One family per form, please. PLEASE COMPLETE ALL FIELDS.

A family is considered to be siblings and the adults accompanying them. If the adults or children in a family are Temple Shalom members, the family is considered to be Temple Shalom members for Munchkin Minyan programs.

Please note that this program fee is non-refundable and not transferable to another session.

* Confirmation Email

* Please choose the number of children attending

Please complete all fields for each child.

* 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

Please complete all fields for each adult.

* Adult Attending First Name

* Adult Attending Last Name

* Email Address

* Mobile

* Relationship to Child

* Temple Shalom member?

Please Select OneYESNO

* Family Street Address

* Family City

* Family 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.

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$10/session for Non-Member Families after the 1st time

$10/session for Non-Member Families after the 1st timePlease check this box if you are a non-member family attending AFTER the first time.

Munchkin Minyan Non-Member Family Registration Fee