To Chabad of Squirrel Hill:
Please enroll my child in the Jewish Discovery Hour  Program  

Child's First Name
Last Name
Phone Number
Cell Number
Email address  
Comment (optional)  

As the Parent or legal guardian of the above child, I enroll my above child in the Jewish Discovery Hour Program, and give permission to Chabad of Pittsburgh to pick my child up from Colfax Elementary School on Thursdays at 2:00pm to participate in the program.

Name      Initials      Date