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Register for Religious School 2018 - 2019

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Our Mission is to inspire and nurture students in forming their Jewish identity and love of Jewish life, while providing a strong understanding of Reform Judaism through the teaching of Jewish history, culture, and values along with Hebrew, prayer, spirituality, Jewish life cycles while deepening our connection to the land of Israel and its people.

The Religious School provides an opportunity for friendship and community building in an environment that welcomes and nurtures students and families and encourages active participation. Our focus is to make learning attainable to all.

Program Highlights

* Small group Hebrew lessons by grade and skill level
* Grounded in Tikkun Olam and Social Action, our Religious School students learn using experiential learning approaches, and lessons focusing on their interests.
* The Temple Israel Religious School utilizes the latest technology to reinforce and teach both Hebrew and Judaic concepts.

First Child's Information

* Child 1: Last Name

* Child 1: First Name

* Child 1: Date of Birth

* Child 1: Hebrew Name

Does your Child own a Shofar?

* Gender

Male
Female

* Child 1: Address

* City, State & Zip Code

* Child 1: Home Phone Number

Child 1: Cell Phone Number (if applicable)

Child 1 Lives With

* Secular School Attending as of August

* Grade as of August

Please share any additional information about your child that would assist in guiding his/her experience through Religious School:

Second Child's Information

Child 2: First Name

Child 2: Last Name

Child 2: Date of Birth

Child 2: Hebrew Name

Does your Child own a Shofar?

Gender

Male
Female

Child 2: Address

City, State & Zip Code

Child 2: Home Phone Number

Child 2: Cell Phone Number (if applicable)

Child 2 Lives With

Secular School Attending as of August

Grade as of August

Please share any additional information about your child that would assist in guiding his/her experience through Religious School:

Third Child's Information

Child 3: First Name

Child 3: Last Name

Child 3: Date of Birth

Child 3: Hebrew Name

Does your Child own a Shofar?

Gender

Male
Female

Child 3: Address

City, State & Zip Code

Child 3: Home Phone Number

Child 3: Cell Phone Number (if applicable)

Child 3 Lives With

Secular School Attending as of August

Grade as of August

Please share any additional information about your child that would assist in guiding his/her experience through Religious School:

Parent 1 Information

I would like to receive Religious School news and updates by email, and I check my email on a regular basis. (Note: You may get an occasional piece of snail mail.)

	Yes
	No

* Parent 1: Title & Full Name

Parent 1: Occupation

Parent 1: Mailing Address (if different from child)

Parent 1: City, State, Zip Code

Parent 1: Home Phone

* Parent 1: Cell Phone

Parent 2 Information

Parent 2: Title & Full Name

Parent 2: Mailing Address (if different from child)

Parent 2: City, State, Zip Code

Parent 2: Home Phone

Parent 2: Cell Phone

Religious School Fees

Pre-Kindergarten through Grade 3

Grades 4 - 7 (Sundays & Midweek Tutorial)

Emergency Medical

In case of emergency, if parents cannot be reached please notify one of the following.

* Name

* Phone Number

* Relationship to Child

Name

Phone Number

Relationship to Child

Medical personnel contact information

* Name of Doctors

* Phone Number

* Name of Dentist

* Phone Number

* Date of child's last tetanus shot

In the event of an emergency, the following information may be necessary in order for your child to receive emergency care at the emergency room of the nearest hospital:

* Insurance Company

* Insured's Name

* Policy Number

* Group Number

I would like to pay the total amount in recurring payments over time.

Account Details

Enter your name and e-mail address for your confirmation:

*E-mail

*First Name

*Last Name

Payment Information

Account

Online Fee:

Credit Card

Name on Card

Card Type

Card Number

Expiration Date

Card Verification Number

Address Line 1

City

State/Province

Zip

Comments

Increase my payment by 3% to cover credit card fees. Please select YES to increase your payment.

Total:

Register for Religious School 2018 - 2019