Yoga with Stephanie | Fall Session One 2024

September 4, 11, 18 & 25, October 2, 9, 16 & 23 | 9:30 am – 10:30 am

Begin the fall season building your strength, balance and alignment through the practice of yoga.

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Thank you for your interest in Shabbat Dinner with Gabby Dagan from Or Hadash. This form is currently closed. Please reach out to Susan Karon at skaron@tbewellesley.org with any questions.

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REGISTRATION

Are you a TBE Member?

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Number of adults attending:

Number of adult members attending:

Number of adult non-members attending:

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Last Name

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First Name

Last Name

Primary Email

Mobile Phone

CUSTOM QUESTIONS

Are you age 65 or older?

Yes

How will you be attending?

In PersonOnline

Will you be taking the bus?

Yes

I would be interested in carpooling with TBE

Yes

TOT SHABBAT DATES

We would like to register for the following dinners:
You can always come back to this form and register for additional dinners in the future!

Month X1, 202X: 5:30pmMonth X2, 202X: 5:30pmMonth X3, 202X: 5:30pmMonth X4, 202X: 5:30pmMonth X5, 202X: 5:30pmMonth X6, 202X: 5:30pmMonth X7, 202X: 5:30pmMonth X8, 202X: 5:30pm

NUMBER OF CHILDREN ATTENDING

Number of youth members attending:

Number of youth non-members attending:

Number of children attending:

First Name (Child #1)

Last Name (Child #1)

Grade (Child #1)

Age (Child #1)

First Name (Child #2)

Last Name (Child #2)

Grade (Child #2)

Age (Child #2)

First Name (Child #3)

Last Name (Child #3)

Grade (Child #3)

Age (Child #3)

First Name (Child #4)

Last Name (Child #4)

Grade (Child #4)

Age (Child #4)

First Name (Child #5)

Last Name (Child #5)

Grade (Child #5)

Age (Child #5)

First Name (Child #6)

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First Name (Child #8)

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SESSION CHOICES

Members

FallWinter Spring ISpring II

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PHOTO & VIDEO PERMISSIONS

I grant my permission to use any and all written comments, pictures, or video in which my child or I may appear for print, audio, visual, and/or electronic publicity promotion and advertising on behalf of TBE and its programs.

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DIETARY RESTRICTIONS & FOOD ALLERGIES

Please list any dietary restrictions and/or food allergies:

GENERAL & MEDICATION ALLERGIES

Please list any general allergies and/or allergies to medications:

MEDICAL CONDITIONS

Please list any medical conditions:

EMERGENCY CONTACT INFORMATION

Emergency Contact #1

Full Name

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Relationship

Emergency Contact #2

Full Name

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Relationship

DONATIONS

Please consider making a donation

BILLING INFORMATION

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Is your mailing address the same as your billing address?

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HIDDEN FIELDS

Form Requests Hidden Fields

FORM #1: ARE YOU A TBE MEMBER?

Yes

FORM #2: # OF ADULTS ATTENDING?

Yes

FORM #3: # OF ADULT MEMBERS ATTENDING?

Yes

FORM #5: # OF ADULT NON-MEMBERS ATTENDING?

Yes

FORM #6: ARE YOU 65 OR OVER?

Yes

FORM #7: HOW WILL YOU BE ATTENDING?

Yes

FORM #8: WILL YOU BE TAKING THE BUS?

Yes

FORM #9: I WOULD BE INTERESTED IN CARPOOLING

Yes

FORM #10: TOT SHABBAT DINNERS

Yes

FORM #11: # OF CHILDREN ATTENDING?

Yes

FORM #12: # OF YOUTH MEMBERS ATTENDING?

Yes

FORM #13: # OF YOUTH NON-MEMBERS ATTENDING?

Yes

FORM #14: SESSION SEASONAL BOXES FOR MEMBERS & NON-MEMBERS?

Yes

FORM #15: PHOTO & VIDEO PERMISSIONS?

Yes

FORM #16: DIETARY RESTRICTIONS & FOOD ALLERGIES

Yes

FORM #17: MEDICAL CONDITIONS

Yes

FORM #18: GENERAL/MEDICATION ALLERGIES

Yes

FORM #19: SUGGESTED DONATION

Yes

FORM #20: TBE Form Password

Yes

FORM #20: EMERGENCY CONTACT (NAME, PHONE NUMBER, EMAIL, RELATIONSHIP

Yes

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