Shaping Lives Sunday Program Application 2026
Welcome! Shaping Lives is a Jewish Sunday school program powered by Chazaq. This is a free program where your child will learn about their Jewish heritage, holidays, traditions, and values. Children will be given an extensive Hebrew reading and writing program with creative projects, educational games, raffles, pizza, and interactive lessons with devoted staff members.
Student's Full Name
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Student First Name
Student Last Name
Date of Birth
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit 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
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Home Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
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example@example.com
Father's Full Name
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Father's First Name
Father's Last Name
Father's Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Full Name
*
Mother's First Name
Mother's Last Name
Mother's Cell Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Name of Emergency Contact
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Emergency Contact First Name
Emergency Contact Last Name
Relationship to Student
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Emergency Contact Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
By checking this box, you agree to receive texts from Chazaq Organization USA Inc. that includes reminders/updates for programs, events, and charity. You may opt out of text messages at any time by responding "STOP". Reply "HELP" for support. Msg frequency varies. Msg & data rates may apply. View our Terms & Privacy Policy.
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.
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Gender of the child?
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Please Select
Male
Female
Which program location are you interested in?
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Rego Park-Ohr Natan (10:00 AM -12:00 PM)
Hewlett 5 Towns-Sephardic Congregation of Hewlett (10:00-11:30 AM)
Great Neck - Kol Israel Achim - R' Alon (10:00-11:30 AM)
Roslyn-The Jewish Center of Roslyn (10:00-11:30 AM)
Jamaica Estates-Shuva Israel of Jamaica Estates (10:00-11:30 AM)
Manhattan Beach- Manhattan Beach Jewish Center (10:00-11:30 AM)
Young Scholars Program- Manhattan Beach Jewish Center (10:00-11:30 AM)
3-5 Year old Program- Manhattan Beach Jewish Center (10:00-11:30 AM)
Oakland Gardens-Young Israel of Hollis Hills-Windsor Park (10:00-11:30 AM)
Mill Basin- Sephardic Congregation of Mill Basin- (10:00-11:30 AM)
One on One Zoom Sessions- Scheduled By Personal Appointment
Kew Garden Hills- Ohel Sara (10:00-11:30 AM)
Midwood -Kehilas Moreshes Yaakov (10:00-11:30 AM)
Forest Hills-Beth Gavriel-(10:00-11:30 AM)
Fresh Meadows-Bat Mitzvah Club (Ages 10-13)-Congregation Bet El (9:30-11:00 AM)
Fresh Meadows- Bet-El (9:30-11:00 AM)
Fresh Meadows-Bet-El (11:00 AM-12:30 PM)
Forest Hills-Congregation of Georgian Jews (10:00-11:30 AM)
Los Angeles-JEM Community Center (10:00-11:30 AM)
Monday Night- Ahavat Shalom of Great Neck (6:00-7:30 PM)
The Sefardic Center - Surfside Florida (10:00 AM-12:00 PM)
Date when student will begin attending Shaping Lives
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Did your child ever attend any programs affiliated with Judaism or Yeshiva?
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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).
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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:
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Referral First Name
Referral Last Name
The suggested donation (for tax deductible, request a receipt), is $40 a month to keep the program running and to pay for the materials, pizza, prizes, books, teachers, etc. or please ask a teacher for a tzedakah box!
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
*
Student First Name
Student 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
2 digit month, 2 digit day, 4 digit year
Date
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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.
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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:
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Date:
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Continue
Continue
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