CTeen Delaware Annual Membership

CTeen is open to all Jewish teens in the Delaware region and will meet throughout the school year in the brand new CTeen lounge! It includes trips, community service projects, social events, holiday parties, Shabbat dinners and more!

Registration for CTeen for the 2025-2026 School Year:
Membership: $360
Subsidized Membership (need-based scholarship price): $275

- This price qualifies you for:
- $225 discount codes for the CTeen International Shabbaton to NYC, which the TEEN will receive in his/her confirmation email
- $350 of total discounts for regional Shabbatons in NJ and Washington, DC
- Free Admission to all CTeen Meetings
- Free Admission to Weekly CTeen Cafes with dinner at the lounge
- Free Admission to all CTeen Shabbat meals
- Free Admission to all CTeen Holiday Events
- Discounts on special CTeen Trips

Thank you to JFD for a $4K contribution towards our budget for the 2025-2026 year.

Regular Price: Number of Teens Registering $360/Teen

Subsidized Price (please contact Rabbi Motti before registering with this option): Number of Teens Registering $275/Teen

Full Name*

First Name Last Name

E-mail*

Phone Number*

Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

School*

Grade*

Birth Date*

Month Day Year

Hebrew Birthday (if known)

Who did you hear about CTeen from?

Please let us know about any allergies or other medical concerns we should be aware of.

Was the maternal grandmother of the teen born Jewish?*

YesNo

Teen 2 - Full Name*

First Name Last Name

Teen 2 - E-mail*

Teen 2 - Phone Number*

Area Code Phone Number

Teen 2 - Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Teen 2 - Grade*

Teen 2 - Birth Date*

Month Day Year

Teen 2 - Hebrew Birthday (if known)*

Teen 2 - Please let us know about any allergies or other medical concerns we should be aware of.

Teen 2 - Who did you hear about CTeen from?

Teen 2 - Was the maternal grandmother of the teen born Jewish?*

YesNo

Teen 3 - Full Name*

First Name Last Name

Teen 3 - Phone Number*

Area Code Phone Number

Teen 3 - Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Teen 3 - Grade*

Teen 3 - Birth Date*

Month Day Year

Teen 3 - Hebrew Birthday (if known)*

Teen 3 - Please let us know about any allergies or other medical concerns we should be aware of.

Teen 3- Who did you hear about CTeen from?

Teen 3 - Was the maternal grandmother of the teen born Jewish?*

YesNo

Teen 4- Full Name*

First Name Last Name

Teen 4 - Phone Number*

Area Code Phone Number

Teen 4 - Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Teen 4 - Grade*

Teen 4 - Birth Date*

Month Day Year

Teen 4 - Hebrew Birthday (if known)*

Teen 4 - Please let us know about any allergies or other medical concerns we should be aware of.

Teen 4- Who did you hear about CTeen from?

Teen 4 - Was the maternal grandmother of the teen born Jewish?*

YesNo

Parent 1 Name*

First Name Last Name

Parent 1 E-mail*

Parent 1 Phone Number*

Area Code Phone Number

Parent 2 Name

First Name Last Name

Parent 2 E-mail

Parent 2 Phone Number

Area Code Phone Number

Acknowledgment:*

I/we give permission for the above mentioned teen to participate in the activities of CTeen Delaware 2022-2023. In consideration of the opportunity of my/our child to participate in the activities of CTeen Delaware, I/we release CTeen Delaware, its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for any loss or injury to my/our child arising from my/our child’s participation in the activities; and I/we agree to indemnify and hold forever harmless CTeen Delaware, its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for loss or injury to my/our child arising from activities of the CTeen Delaware. As the parent(s) or legal guardian(s) of above mentioned teen participant, I/we give permission for CTeen Delaware, its agents, staff, and volunteers to obtain urgent or emergency medical care for my/our child, and I/we authorize health care providers to render such care as may be necessary. It is understood that reasonable efforts will be made to contact me/us prior to obtaining such care, but I/we authorize such care whether I/we are contacted or not, and I/we agree to be financially responsible for such care.

I'd like to Support CTeen DE Programs and Activities! Please enter donation amount

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Total

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Payment

Credit Card

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Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Teen 1 Information

Teen 2 Information

Teen 3 Information

Teen 4 Information

Parent/Guardian Information

Permissions and Liability Waiver

Donation

Payment