BBYO (Lake Ontario Region)

Program Bank ∙ Build a Prayer ∙ Dashboard ∙ BBYO International

	BBYO Lake Ontario Region 4588 Bathurst Street #1-22 Toronto, ON M2R 1W6 T. 416.398.2004 ∙ F. 416.398.5780 info@bbyo.ca
Meaningful Jewish Experiences for Toronto-area Teens

Membership Registration

Required fields are marked with a *

Participant Information:

* Last Name * First Name * Grade Chapter * Birthday

*Teens become eligible for membership in January of 8th grade.

Address City Province Postal Code

* Home Phone Cell Phone * Email Address

Parent Information:

* Parent 1 - Name * Home Phone Cell Phone * Email Address

Parent 2 - Name Home Phone Cell Phone Email Address

Payment Information:

Is this Membership a gift?

Check if Yes and we'll send a card!

	From:
	Message:

* Membership Fee:

Donation to Scholarship Fund:

Tax receipts will be issued.
Your optional contribution to BBYO's scholarship fund helps to ensure no teen is unable to participate due to financial reasons.

Total Payment is Membership Fee + Optional Donation

Refund Policy: For requests received within 30 days of membership registration a full refund will be issued. No refunds will be issued after 30 days.

Scholarship: BBYO is committed to providing meaningful Jewish experiences to all Jewish teens. Membership scholarships are available based on need and vary subject to the availability of funds. Please check here if you would like to be considered for a scholarship and our Regional Office will contact you with further details:


* Payment Method	Card Number	Expiry Date	Name Of Card Holder:

* If selecting payment by Cash or Cheque, your membership will not be processed until payment is received by BBYO. Please submit payment to: BBYO - 4588 Bathurst Street #1-22, Toronto, ON M2R 1W6