Shaping Lives Sunday Program Application 2025-2026
Welcome to Shaping Lives!Powered by Chazaq, this free Jewish Sunday School class is for children ages 3.5–5. Your child will discover the joy of Jewish heritage, holidays, traditions, and values in a warm, engaging environment. Through our extensive Hebrew reading and writing program, children will build foundational language skills while enjoying creative projects, educational games, raffles, pizza, and interactive lessons led by our devoted and caring staff.
Student's Full Name
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First Name
Last Name
Date of Birth
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Month
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Day
Year
Date
Address of Parent/Guardian:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Attending: Please specify which school. (Also mention if Public, Homeschool, or Yeshiva if not clear by the name)
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Grade
*
Home Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Father's Full Name
*
First Name
Last Name
Father's Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Full Name
*
First Name
Last Name
Mother's Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Emergency Contact
*
First Name
Last Name
Relationship to Student
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
*
By providing phone number/contact information, you consent to receiving weekly SMS text messages as well as on a WhatsApp group that include reminders/updates about the program.
By providing phone number/contact information, you consent to receiving weekly SMS text messages as well as on a WhatsApp group that include reminders/updates about the program.
*
Is your child a male/female?
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Please Select
Male
Female
Which program are you interested in?
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Manhattan Beach- Manhattan Beach Jewish Center (10:00-11:30 AM) Ages 3.5-5
Date when student will begin attending Shaping Lives
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-
Month
-
Day
Year
Date
Did your child ever attend any programs affiliated with Judaism or Yeshiva?
*
Please Select
Yes
No
If yes which one/s?
Does your child have any allergies?
*
Please Select
Yes
No
If yes, please specify:
Are you interested in Yeshiva Placement? (If yes, please expect a call from the PSTY Division of Chazaq).
*
Please Select
Yes-This upcoming school year
No
Maybe in the future
Maybe now-I want more information
Already attending Yeshiva
How did you find out about the program?
*
Please Select
Facebook
Instagram
WhatsApp
Newsletters/Newspapers
Flyer
Parent Referral
If a parent from our program referred you, please put in their name. If no one referred you from our program, please put N/A in both boxes:
*
First Name
Last Name
Media Consent
Consent to photograph, film, or videotape a student for non-profit use (e.g. educational, public service, or health awareness purposes).
Student's Full Name
*
First Name
Last Name
I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or video tapes of the student named above by parent/guardian. I also grant Chazaq Organization USA the right to edit, use, and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release Chazaq Organization USA and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above. Signature of Parent/Guardian:
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Date
*
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Month
-
Day
Year
Date
*
I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or video tapes of the student named above by parent/guardian. I also grant Chazaq Organization USA the right to edit, use, and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release Chazaq Organization USA and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above.
*
I hereby release Chazaq Organization USA of any medical, psychological, health, and injury related issues and/or damage, and expenses related to such incidents.
I hereby release Chazaq Organization USA of any medical, psychological, health, and injury related issues and/or damage, and expenses related to such incidents. Signature of Parent/Guardian:
*
Date:
*
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Month
-
Day
Year
Date
Submit
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