Hebrew School Registration 2020-2021

Guardian 1:Name

Guardian 1: Phone Number

Guardian 1: Email

Guardian 1: Address Line 1

Guardian 1: Address Line 2

Select State

Guardian 2: Name

Guardian 2: Phone Number

Guardian 2: Email

Guardian 1: Address Line 1

Guardian 2: Address Line 2

Select State

Emergency Contact Name (Not Guardian)

Relationship

Emergency Contact Phone Number

Child 1

Child 1 - School

Child 1 - Grade (2020-2021 School Year)

Please describe any relevant medical (including food allergies), developmental or learning conditions concerning your child, so that we may best meet your child's needs.

Child 2

Child 2 - School

Child 2 - Grade (2020-2021 School Year)

Please describe any relevant medical (including food allergies), developmental or learning conditions concerning your child, so that we may best meet your child's needs.

Child 3

Child 3 - School

Child 3 - Grade (2020-2021 School Year)

Please describe any relevant medical (including food allergies), developmental or learning conditions concerning your child, so that we may best meet your child's needs.

Child 4

Child 4 - School

Child 4 - Grade (2020-2021 School Year)

Please describe any relevant medical (including food allergies), developmental or learning conditions concerning your child, so that we may best meet your child's needs.

Medical Emergency: I grant authorization and consent for Temple B'nai Israel to summon professional emergency personnel to attend, transport and treat my student, and to issue consent for any medical treatment. I agree to assume financial responsibility for all expenses of such care. PLEASE SIGN

May we take photos and videos of your child to post in Temple Bulletins, newsletters and on social media? YES or NO

The enrollment fee is $265.00 per student. You have the option to pay in full today, or pay a deposit of $36.00, and have the remainder of your fee charged in three equal installments on your August 1, September 1 and October 1 billing statements. If you require financial assistance, please contact Zemer Sweenie at 405-848-0965 or tbimusic@coxinet.net for more information. .

Number of Children Enrolled

Enter Total Due = Number of Students Enrolled x $265.00

If Paying in Full Today, Enter Total Here. Otherwise Enter 0

Pay $36.00 Deposit Today

Wed, April 24 2024
16 Nisan 5784

Upcoming events

Wed, April 24 2024 16 Nisan 5784