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PARENTAL AFFIRMATION OF JEWISH COMMITMENT for my daughter In the presence of the undersigned Bet Din, I, ____________________________________________, hereby affirm the conversion to Judaism of my daughter, _________________________________________________________________ (English name) _________________________________________________________________ (Hebrew name) My affirmation of my daughter’s Jewish commitment has taken place in accordance with my express wish and at my specific request. I pledge to rear my child according to the teachings of the Torah and the practices of Judaism, and in no other faith. I undertake to provide her with a formal Jewish Education, supported through my synagogue affiliation and regular attendance at its religious services, and through the creation of an atmosphere of Jewish living and religious observances in my home. Today, with authorization by the Sandra Caplan Community Bet Din, I shall immerse my daughter in the mikveh as a sign of my commitment to raise her in the Jewish tradition. Even so, I understand that at the age of religious majority, she shall have a one-­‐time option to renounce the Jewish decision that the Bet Din has made for her, which would annul this conversion. May God help me to raise my child to appreciate the beauty of Judaism and lead her to a fulfilling life of Torah, Huppah, and Maasim Tovim. Signature: _____________________________________________________________________________________________ Date: ______________________________________________ Dayanim of the Sandra Caplan Community Bet Din of Southern California: _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ C6