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TBE Religious School Registration for 2023-24
Please verify reCaptcha before submitting the form.
ShulHouse Rock and J
oint Religious School Registration Form
All TBE Families should enroll their children in Temple Beth El’s ShulHouse Rock Program
Families may enroll each child in ShulHouse Rock AND in the Joint Religious School.
Joint Religious School Classes will be held at
Temple Emanu El.
(Note: You must be a member-in-good standing at Temple Beth El in order to enroll in the Joint Religious School.
Enrollment in ShulHouse Rock is also required.).
OR
If not enrolling in Religious School, families may enroll each child in ONLY ShulHouse Rock, which includes Family Shabbat and Holiday Programming for all ages here at Temple Beth El.
To enroll in ShulHouse Rock programming ONLY,
click here.
To enroll in ShulHouse Rock AND to enroll your child in the Joint Religious School, please complete the form below.
**You will need to complete a separate form for
each child
you are registering**
*
Email Address
*
Are you a member of Temple Beth El?
Please select one
Yes
No
You MUST be a member of Temple Beth El to enroll in Religious School
Yes, I am a member.
Yes
Non-Members enrolling in
ShulHouse
Rock Only Register by clicking on the link.
ShulHouse Rock Only Registration Form
Parent Information
*
Parent 1 First Name
*
Parent 1 Last Name
*
Parent 1 Email
*
Parent 1 Cell Phone
Parent 1 Employer
Parent 1 Business Phone
Parent 2 First Name
Parent 2 Last Name
Parent 2 Email
Parent 2 Cell Phone
Parent 2 Employer
Parent 2 Business Phone
*
Address
*
City
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip
Photo Opt Out
Photo Opt Out
If you
DO NOT
wish your child(ren)'s picture to appear as part of a group in Temple Beth El's orTemple Emanu-El's communications or publications, please check this box.
Emergency Contacts
*
Emergency Contact Name
*
Emergency Contact's Relationship to Student
*
Emegency Contact Phone 1
Emergency Contact Phone 2
*
Emergency Contact Email
Emergency Contact Name
Emergency Contact's Relationship to Student
Emegency Contact Phone 1
Emergency Contact Phone 2
Emergency Contact Email
Carpool Permission
Please check here if you are interested in carpooling with other families
Please check here if you are interested in carpooling with other families
Please list everyone who has permission to pick up your child in carpool.
Please note we may ask for identification
Please list anyone who is prohibited from picking up your child and their relationship.
Please note if the person you list is the child's parent, we may require official documentation..
Student Information
*
Student First Name
*
Student Last Name
Student Hebrew Name
*
Student prefers to be called
*
Student Birthdate
*
Secular School attending Fall 2023
*
Religious School Grade Fall 2023
Please Select One
Pre-K
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Kesher Community High School 8, 9, 11 - 12th Grade
10th Grade Kesher and Required Confirmation Fee
*
Student Resides With:
Please Select One
Parent 1 and Parent 2
Parent 1
Parent 2
Other
If other please specify
Student Email
All emails sent to students will be cc'd to parent
Please provide any additional information about your child regarding learning, social, or behavior issues to help us offer the best possible school experience:
Medical Info and Release
*
Medical Release & Liability
Medical Release & Liability
I hereby grant permission for my child(ren) to participate in all Temple youth programs, activities and events and do release Temple Beth El and its representatives from all liability arising out of my child’s participation in such activity. In addition, I, the undersigned parent/guardian of the above child(ren), do further certify that my child(ren) is physically able to participate in such activity. By selecting 'I agree' below and by enrolling your child(ren) in Religious School at Temple Emanu-El via Temple Beth El, you indicate your agreement to the above terms and conditions
Does your child take any prescriptions or have any medical conditions we should be aware of?
My child is allergic to:
Peanuts and /or peanut products
Tree Nuts
Eggs
Dairy
Latex
Other
If you checked other in Allergies, please specify:
If your child carries an EpiPen, please make sure the teachers and staff are aware of where it can be found.
Payment Information
Amount Due for this Registration
Amount due for this registration. You must fill out and pay for each child separately. After you submit the first registration, you'll create a new registration form for each additional child.
As a reminder, you will need to register each child separately.
Things to remember:
TBE dues for 23/24 must be paid or a payment plan set up by August 10, 2023.
Enrollment in the Joint Religious School is not confirmed until the TBE Finance Office verifies dues payment.
Religious School fees are due in full at time of enrollment.*
*
Contact the office if you have questions about this policy.
Wed, May 15 2024 7 Iyyar 5784