Valley Tzelem+ Registration Form

Valley Tzelem+

a brave and safe space for Jewish LGBTQ+ teens from across the San Fernando Valley.
&
a simultaneous parent support group

Meetings are Monday evenings from 6:30-8:00pm at Temple Judea.
'23-'24 Teen Dates:
Sept. 18 | Oct. 2 | Oct. 16 | Nov. 6 | Nov. 27 | Dec. 11 | Jan. 8 | Jan. 22 | Feb. 5 | Mar. 4 | Mar. 18 | Apr. 1 | Apr. 15 | May 6 | May 20

‘23-’24 Parent Dates
Oct. 2 | Nov. 6 | Dec. 11 | Jan. 8 | Feb. 5 | Mar. 4 | Apr. 1 | May 6

Tzelem offers opportunities to make friends and explore issues such as:
- Gender
- LGBTQ+ Identities
- Wellness
- Friendship
- Jewish Identity

The teen group facilitator is Becker Grumet, AMFT
The adult support group will be facilitated by Nicole Rosenson, MA, AMFT.

Costs: Teen Tzelem Group - $300/teen
Parent Support Group - $275/family
Scholarships available for financial concerns; please email RabbiRosenstein@templejudea.com

For more information, visit: templejudea.com/tzelem

Please check the box and complete the form for each teen participating in Tzelem.

Teen Tzelem Group: $300 (includes 15 dates)

Teen Tzelem Group: $300 (includes 15 dates)Select the box above to participate in this program.

* Teen First Name

This is the name that the participant will want to be addressed by.

* Teen Last Name

Teen Personal Pronouns

Please let us know what pronouns the participant will want to be addressed by.

* Teen Grade

Teen Email

Teen Mobile

To complete a teen's registration, please complete the parent information below.
To also register for the parent support group, please click the box at the bottom of this section.

* Parent 1 First Name

* Parent 1 Last Name

* Parent 1 Email

* Parent 1 Mobile

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Mobile

Parent Support Group: $250

Parent Support Group: $250OPTIONAL: Select the box above to participate in this program. This adult support group will meet concurrently with the teen group.

Facilitated by:
Nicole (Nikki) Rosenson, MA, AMFT
Registered: #125403
Employed & supervised by:
Lucy Rimalower Marriage & Family Therapy, Inc

Please share which Valley congregation/community you're joining us from.

Questions or comments?

Wed, April 24 2024 16 Nisan 5784