Religious School Reg. Form

CONGREGATION B'NAI ISRAEL RELIGIOUS SCHOOL REGISTRATION FORM
       
This online form provides an accessible and user-friendly method to register your children for Religious School. The information obtained in this form is delivered to the Religious School Director after pressing the "submit" button at the bottom.
 
2017-2018 Tuition*:
Grades Preschool - 4th           $340.00
Grades 5-7                             $660.00
Grade 8                                 $340.00
B'nai Mitzvah                         $600.00**
Confirmation                          $330.00
Supply Fee (per child)             $ 40.00
M&Ms                                      FREE
 
* Tuition stated above is applicable for members of Congregation B'nai Israel. Please contact Jessica Yellen with questions regarding non-member tuition.
** A deposit of $300.00 is due with the Bar/Bat Mitzvah reservation form. The remainder is paid at the beginning of the school year that preceeds the Bar/Bat Mitzvah date.
Invoices will be sent out through the Temple Administrative Office prior to the start of the school year. PLEASE NOTE: Children will not be officially registered for the new school year until all previous balances have been resolved.
 
Registration Form:
Please complete all of the following information.   All personal information is treated with respect and confidence by the Congregation B'nai Israel Staff. If you have any questions or would like to go over anything regarding Religious School, please contact Jessica Yellen.
 
By completing this registration form, I agree to the following:  to encourage Jewish Education by making the effort to bring my child(ren) regularly and on time to Congregation B'nai Israel Religious School and to support Jewish values by helping my child(ren) to treat students and teachers with respect, to keep their hands, feet, and all objects to themselves, and to keep all electronic toys (ie: iphones, games) at home during Religious School hours (unless asked to bring it for educational purposes).


PARENT 1 Last Name
PARENT 1 First Name
Address
City
Zip Code
Cell Phone
Home Phone
Email Address
PARENT 2 Last Name
PARENT 2 First Name
Address (If different than Parent 1)
City
Zip Code
Cell Phone
Home Phone
Email Address
Are you a member of CBI?    Yes
   No
CHILD 1 Full Name
Hebrew Name
Date of Birth (mm/dd/yyyy)
Age
Grade in School (August 2017)
School Attending in August 2017
Please list all ALLERGIES or DIETARY RESTRICTIONS
Please list all HEALTH CONCERNS, and/or LEARNING OR BEHAVIORAL ISSUES
Please list all MEDICATIONS
       
Does your child take his/her medication on Sundays?
Please register your child by selecting the class(es) below:
Preschool - 4th Grade
Grade 5 - 7
Grade 8
B`nai Mitzvah (as approved by the school)
Grades 9-10 Confirmation
Mini Mishpocha Parent and Me Playtime: M&Ms
CHILD 2 Full Name
Hebrew Name
Date of Birth (mm/dd/yyyy)
Age
School Attending in August 2017
Grade in School (August 2017)
Please list all ALLERGIES or DIETARY RESTRICTIONS
Please list all HEALTH CONCERNS and/or LEARNING OR BEHAVIORAL ISSUES
Please list all MEDICATIONS
Does your child take his/her medication on Sundays?
Please register your child by selecting the class(es) below:
Preschool - 4th Grade
Grade 5 - 7
Grade 8
B`nai Mitzvah (as approved by the school)
Grades 9-10 Confirmation
Mini Mishpocha Parent and Me Playtime: M&Ms
CHILD 3 Full Name
Hebrew Name
Date of Birth (mm/dd/yyyy)
Age
School Attending in August 2017
Grade in School (August 2017)
Please list all ALLERGIES or DIETARY RESTRICTIONS
Please list all HEALTH CONCERNS and/or LEARNING OR BEHAVIORAL ISSUES
Please list all MEDICATIONS
Does your child take his/her medication on Sundays?
Please register your child by selecting the class(es) below:
Preschool - 4th Grade
Grade 5 - 7
Grade 8
B`nai Mitzvah (as approved by the school)
Grades 9-10 Confirmation
Mini Mishpocha Parent and Me Playtime: M&Ms
EMERGENCY Contact Name and Phone Number(s) (Non-Parent)
PHYSICIAN Name and Phone Number
Are all children current on all immunizations?
I authorize the Staff of Congregation B'nai Israel Religious School to engage such professional medical care or hospital laboratory services as may appear to be necessary or desirable for the protection of the health or life of my minor child(ren) on this registration form.  Further, I agree to be responsible for any charges incurred in the rendition of such care and treatment.
Please click here for authorization:    I Agree
 I agree to pay the above tuition in full or will make financial arrangements with the Temple Office Administrator by the Religious School Opening Day 2017.  I understand that there are circumstances when scholarships are considered and that it is my responsibility to contact the Religious School Director before the Religious School Opening Day 2017 for an application. I also understand that I cannot officially register my children until all previous balances have been resolved. 
Please click here for authorization:    I Agree
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