Bar Mitzvah Lessons are at the Chabad House- 9960 Dufferin Street Unit 13 (in the Higland Farms Plaza) generally on Sunday mornings and Wednesday afternoon / evenings. (Alternative arrangements can be made)

Please fill out this registration form below to the best of your ability. Upon receipt of this form I will contact you and arrange the lesson times.

For questions or help filling out the form please contact Rabbi Chezky Deren   647.883.6372 or  [email protected]  


Bar Mitzvah Boy - Student Information

First Name


Last Name

Hebrew Name



Street Address

Province     Postal Code
Home Phone     Email
School     Hebrew School
Jewish Birthday     Bar Mitzvah Parsha
Date of Aliya and Reading from the Torah     Where is Aliya taking place?
Shul Affiliation      
Where will Tefillin be purchased from?        
Parent Information
Mother's Name     Father's Name
Hebrew Name     Hebrew Name
Mother's Work     Father's Work
Mother's Cell     Father's Cell
Is Mother Jewish?     Is Father Jewish?
Mother's Mother's Name (Hebrew)     Father's Mother's  Name (Hebrew)
Mother's Father's Name (Hebrew)     Father's Father's Name (Hebrew)
Are mothers parents both Jewish? If not, Please elaborate.     Have any family members been adopted or converted to Judaism? If yes please elaborate.

Payment & Fees: 

Payment should be made to Chabad of Maple. The cost per a lessons is $45. Regular lessons are half hour. At the initial meeting we will discuss the number of lessons needed. (45 minute lessons are $65)

Fees for lessons are due at the end of each month. A tax receipt for religious instruction can be provided upon request.


$45.00 - Half hour Lesson



   $65.00 - 45 minute lesson

I will be paying by: Credit Card  Other (Cheque, Cash, or E-transfer to [email protected])

Card Type   Card Number
Expiration Date     Security Code            

I confirm that all the details provided above are accurate, to the best of my knowledge.

Parent's Digital Signature: 

For help filling out the form please contact Rabbi Chezky Deren 
647.883.6372 or [email protected]