REGISTRATION FORM 2017 - 2018

BETH EL - NER TAMID RELIGIOUS SCHOOL

*Student's Full Name:     Date of Registration: 05/14/2021
*Hebrew Name: *Date of Birth: Year
*Address:     *Home Number: ()--
Father's Name: Father's Email:
Father's Address: Phone Number: ()--
Father's Cellphone: ()-- Business Number: ()--
Mother's Name: Mother's Email:
Mother's Address: Phone Number: ()--
Mother's Cellphone: ()-- Business Number: ()--
*Student's Secular School & District: *Grade:
Previous Religious Schools Attended: Years Attended:
*Select Religious School Class for 2016-2017 (Please note - name change of classes)
Gan (Kindergarten)
Dalet (4th Grade)
Aleph (1st Grade)
Hey (5th Grade)
Bet (2nd Grade)
Vav (6th Grade)
Gimel (3rd Grade)
Zayin (7th Grade)
Confirmation/Hebrew High
(8th, 9th & 10th Grades)
Describe any learning styles/differences that will help us in understanding your child. This information is strictly confidential. There is no greater way for you to help us educate your children then by helping us understand your child's educational learning style.
I authorize you to release my child at dismissal time to the following individuals:

Emergency Contact

In case of emergency, if no one is available at the above phone numbers, please contact:

*Name: *Phone #: ()-- *Relation to Minor:
Yes, I give permission for our contact information to be used in a school directory that is accessible online with a common password for the school community.
I agree to authorize Congregation Beth El - Ner Tamid to utilize photographed or video graphed images of my child in brochures, flyers, displays or other promotional purposes without compensation from the synagogue or related organizations.
*Parent or Guardian's Name:             Date: 05/14/2021

+ REGISTER ANOTHER CHILD



REGISTER CHILD #2

*Student's Full Name:     Date of Registration: 05/14/2021
*Hebrew Name: *Date of Birth: Year
*Address:     *Home Number: ()--
Father's Name: Father's Email:
Father's Address: Phone Number: ()--
Father's Cellphone: ()-- Business Number: ()--
Mother's Name: Mother's Email:
Mother's Address: Phone Number: ()--
Mother's Cellphone: ()-- Business Number: ()--
*Student's Secular School & District: *Grade:
Previous Religious Schools Attended: Years Attended:
*Select Religious School Class for 2016-2017 (Please note - name change of classes)
Gan (Kindergarten)
Dalet (4th Grade)
Aleph (1st Grade)
Hey (5th Grade)
Bet (2nd Grade)
Vav (6th Grade)
Gimel (3rd Grade)
Zayin (7th Grade)
Confirmation/Hebrew High
(8th, 9th & 10th Grades)
Describe any learning styles/differences that will help us in understanding your child. This information is strictly confidential. There is no greater way for you to help us educate your children then by helping us understand your child's educational learning style.
I authorize you to release my child at dismissal time to the following individuals:

Emergency Contact

In case of emergency, if no one is available at the above phone numbers, please contact:

*Name: *Phone #: ()-- *Relation to Minor:
Yes, I give permission for our contact information to be used in a school directory that is accessible online with a common password for the school community.
I agree to authorize Congregation Beth El - Ner Tamid to utilize photographed or video graphed images of my child in brochures, flyers, displays or other promotional purposes without compensation from the synagogue or related organizations.
*Parent or Guardian's Name:             Date: 05/14/2021
*Anti-Spam: check box please