Bar Mitzva lessons are at Chabad of Maple - 9960 Dufferin Street Unit 4 (in the LCBO Plaza on the SW corner of Dufferin St. and Major Mackenzie Dr.) on Sunday mornings and Wednesday afternoon / evenings.

Please fill out this registration form below to the best of your ability. Upon reciept 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  

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)
Who from the Mother's Parents are Jewish?     Have any family members been odopted or converted to Judaism? If yes please explain.

Payment & Fees: 

The cost per a lessons is $40. Regular lessons are half hour. At the initial meeting we will disscuss the number of lessons needed. (Longer 45 minute lessons are available for $60)



Half hour Lesson



45 minute lesson

Fees's for lessons are due at the beginning of each month.
I will be paying by: Credit Card  Check 

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 Signature: 

For help filling out the form please contact Rabbi Chezky Deren 
647.883.6372 or