Religious School Registration

Welcome to another year at the Koven Religious School!

Please use this form to sign up your child(ren) for grades K-12.

Kindergarten meets on Sundays from 9:30am-12noon,
Grades 1-6 meet Sundays from 9:30am-12noon and Wednesdays from 4:30-6:30pm,
Grades 7-8 meets Sundays from 9:30am-12noon with the option of being a madrich (teacher’s assistant) on Wednesdays, and
Grades 9-12 meet Sundays from 9:30am-12noon on alternating weeks. If your 9th-12th grader is interested in being a madrich (teacher’s assistant) on the weeks they don’t have class, please have them email Principal David Schwartz at dschwartz@wsthz.org.

PARENT INFORMATION

* Parent 1 First Name

Parent 2 First Name

* Parent 1 Last Name

Parent 2 Last Name

* Parent 1 Address Line 1

Parent 2 Address

If same as Parent 1, write “Same”

Parent 1 Address Line 2

Parent 2 Address Line 2

* Parent 1 City

Parent 2 City

* Parent 1 State

Parent 2 State

* Parent 1 ZIP Code

Parent 2 ZIP Code

* Parent 1 E-mail Address

Parent 2 E-mail Address

* Parent 1 Cell Phone Number

Parent 2 Cell Phone Number

* If a parent can’t be reached, please contact these 2 people

Include name, cell phone number, and relationship to student(s)

If there is any contact info you don't want shared with fellow parents in your child(ren)'s grade, please indicate it here:

Options include: Address, home phone, cell phone, and e-mail addresses. Other things that might be shared include your child's birthdate, Hebrew name, and grade.

STUDENT INFORMATION

* How many children are you registering this year?

* Child 1 Name

Child 2 Name

Child 3 Name

Child 4 Name

* Child 1’s Hebrew name (if known)

Child 2’s Hebrew name (if known)

Child 3’s Hebrew name (if known)

Child 4’s Hebrew name (if known)

* Child 1 Birthday

Child 2 Birthday

Child 3 Birthday

Child 4 Birthday

* Child 1 Grade This Fall

Child 2 Grade This Fall

Child 3 Grade This Fall

Child 4 Grade This Fall

* Child 1 School This Fall

Child 2 School This Fall

Child 3 School This Fall

Child 4 School This Fall

* Child 1 Jewish Summer Camp

Child 2 Jewish Summer Camp

Child 3 Jewish Summer Camp

Child 4 Jewish Summer Camp

* Child 1 Allergies

If none, put “None”. If other food restrictions or medical issues, please indicate that also.

Child 2 Allergies

If none, put “None”. If other food restrictions or medical issues, please indicate that also.

Child 3 Allergies

If none, put “None”. If other food restrictions or medical issues, please indicate that also.

Child 4 Allergies

If none, put “None”. If other food restrictions or medical issues, please indicate that also.

* Child 1 Learning Challenges

What learning challenges does your child have? (Example: ADD/ADHD, Autism Spectrum, Learning Disability, Speech/Language Disability, Hearing Disability, Vision Disability beyond glasses, Emotional/Behavioral Disorder). If “none”, put “none”. If your child has an IEP or 504 Plan, please e-mail a copy to David at dschwartz@wsthz.org - it will be kept confidential.

Child 2 Learning Challenges

Child 3 Learning Challenges

Child 4 Learning Challenges

* Is Child 1 receiving free books each month?

To sign up kids ages 0-8, go here: https://pjlibrary.org/enroll-in-a-community?id=38
To sign up kids ages 9-12, go here: https://www.pjourway.org/About

Is Child 2 receiving free books each month?

To sign up kids ages 0-8, go here: https://pjlibrary.org/enroll-in-a-community?id=38
To sign up kids ages 9-12, go here: https://www.pjourway.org/About

Is Child 3 receiving free books each month?

To sign up kids ages 0-8, go here: https://pjlibrary.org/enroll-in-a-community?id=38
To sign up kids ages 9-12, go here: https://www.pjourway.org/About

Is Child 4 receiving free books each month?

To sign up kids ages 0-8, go here: https://pjlibrary.org/enroll-in-a-community?id=38
To sign up kids ages 9-12, go here: https://www.pjourway.org/About

* Photo Release Policy

Photo Release PolicyI acknowledge the following Har Zion photo release policy and will contact David Schwartz at dschwartz@wsthz.org if I want to opt out of this:

It is the practice of Har Zion to use photographs, videos, and quotations of youth involved in synagogue activities in its programs, publications, websites, and the social media of the synagogue for the purpose of promoting the synagogue and its programs. No children will be identified by name in any photograph shared by Har Zion.

* Medical Permission

Har Zion may secure medical care for my child(ren) in the event of an emergency.

* Field Trip Permission

My child(ren) may participate in field trips with the Koven Religious School.

Notes

Please share anything else that will enable everybody to have the best year possible.

PAYMENT

Number of students grades 1-6 ($1400)

Number of students grades 7-12 ($700)

Number of students grade K ($700)

Number of entering Kindergarteners who were in the Har Zion Preschool this past year

I have 3 children enrolled in the Koven Religious School this year

Har Zion wants Jewish education to be accessible to everybody. If you would like to make a contribution to help another family to attend our school, please enter the amount here.

For reference, a semester is $700, and a year is $1400, but any amount is helpful.

Total Amount Due

Temple Har Zion does not want finances to be a barrier for anybody. If you need confidential assistance, please submit, then choose “Bill to my account”, and then e-mail David at dschwartz@wsthz.org to discuss.

Wed, October 23 2024 21 Tishrei 5785