Hebrew School Registration 2022 - 2023 - Form

* Parent #1 name

* Cell phone number

Home phone number

* Email address (required)

Parent #1 Hebrew name

Street address

Town/city

State

Zip code

Parent #2 name

Cell phone number

Home phone number

Email address (required)

Parent #2 Hebrew name

Street address (if different than parent #1)

Town/city

State

Zip code

Would you like to be included in the Hebrew school telephone directory?

YesNo

* PHOTOGRAPHY RELEASE: I agree that photographs and video taken during the course of Hebrew School classes or any other CBI activities that contain images of my child(ren) or other family member, may be used for publicity by Congregation B’nai Israel, and may be included on the temple’s website. Submitted photos of children never include the name(s) without parental consent.

Please Select OneYesNo

* Parent's typed name confirms answer.

Emergency contact information

* Contact #1 name

* Cell phone number

* Can your child go home with this person?

Please Select OneYesNo

* Relationship to child

Contact #2 name

Cell phone number

Can your child go home with this person?

YesNo

Relationship to child

Contact #3 name

Cell phone number

Can your child go home with this person?

YesNo

Relationship to child

Medical information

Doctor's name

Phone number

Address

* Medical insurance company

* Member ID number

* If emergency medical treatment is required, I authorize CBI’s employees to use their judgment in sending my child(ren) to the hospital or doctor. I understand that CBI will make efforts to notify me when such a situation occurs. Parent's typed name confirms answer.

Additional family information: Please list the name and age of all children, who will NOT be enrolled in this Hebrew School year who (1) will be enrolled in future years (this helps us plan ahead) or (2) are beyond Hebrew School age

Post bar/bat mitzvah student volunteer opportunities

Student name

Cell phone number

Volunteer on Tuesdays during Hebrew schoolVolunteer on projects for the Principal

Temple involvement opportunities

The Hebrew school of Congregation B’nai Israel strongly encourages parents to be active in synagogue life. Your participation in the synagogue will help to teach your child the importance of being Jewish. We ask you to volunteer to assist in at least one area. Please check area(s) below in which you wish to volunteer. SUGGESTIONS ARE WELCOME!!

Class Parent - Assist in phone chain to contact families concerning emergency closings, class service reminders, etc.Holiday Workshops - Set-up, food, general assistance.Purim Carnival - Assist in preparing, set-up, running and dismantling of CBI’s annual Purim Carnival – Feb./March.School Fundraisers - Assist in distribution and processing of fundraiser information – Fall and/or Spring.Class Oneg, Kiddush and/or Shabbat Dinner - Assist in set-up and clean-up for your child’s class religious service on Friday night or Saturday morning or assist with the Shabbat dinner the night of the class religious service on Friday night.Casual Shabbat Dinner - Assist in set-up and clean-up for casual Shabbat Dinner and Oneg. You will be contacted to see which casual Shabbat you are available to assist with.Family Shabbat - Assist in the Family Shabbat service, Saturday mornings. You will be contacted to see which Family Shabbat you are available to assist with.Tutor - Help by working one-on-one with students in areas of elementary Hebrew reading and singing prayers. Hebrew School graduates are also welcome to tutor.I would like to become more active in the synagogue. Please contact me with information about other synagogue activities, such as Social Action Committee, Good and Welfare, etc.

Student #1

* Full name

Hebrew name

Street address (if different than parent #1)

Town/city

State

Zip code

* Date of birth

Public school grade as of Sept. 2022

* Hebrew school program

Prior religious school information -Temple / JCC Name, City, State and number of years attended:

Please list any medical conditions or allergies the principal and teachers should be aware of

List any medicines your child needs to take during Hebrew school hours

Please inform us of any other information that will help us provide your child with the best possible educational environment (i.e. learning disabilities, divorce, etc.).

Student #2

Full name

Hebrew name

Street address (if different than parent #1)

Town/city

State

Zip code

Date of birth

Public school grade as of Sept. 2022

Hebrew school program

Prior religious school information -Temple / JCC Name, City, State and number of years attended:

Please list any medical conditions or allergies the principal and teachers should be aware of

List any medicines your child needs to take during Hebrew school hours

Please inform us of any other information that will help us provide your child with the best possible educational environment (i.e. learning disabilities, divorce, etc.).

Student #3

Full name

Hebrew name

Street address (if different than parent #1)

Town/city

State

Zip code

Date of birth

Public school grade as of Sept. 2022

Hebrew school program

Prior religious school information -Temple / JCC Name, City, State and number of years attended:

Please list any medical conditions or allergies the principal and teachers should be aware of

List any medicines your child needs to take during Hebrew school hours

Please inform us of any other information that will help us provide your child with the best possible educational environment (i.e. learning disabilities, divorce, etc.).

Total due

Thank you for registering!

A deposit of $300/child is required upon submitting this form. Please click on "submit" below to be taken to Paypal, our credit card processor. You do not need a Paypal account to make a payment.

Tuition is subject to change and will be billed on July 1st. A $25 multi-child discount will be credited to your account if you are registering more than one student.