JFE Registration

Jewish Family Experience Registration Form 2024-2025

A Sunday Jewish enrichment program, powered by the Jacksonville Community Kollel
Child's Information
Name*

First NameLast Name
Hebrew name (if applicable)
Birth Date*

MonthDayYear
Current school*
Previous Jewish education (if applicable)
Grade for 2024-2025 School Year*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like to register a second child?*

YesNo
Second Child Name*

First NameLast Name
Hebrew name (if applicable) {2nd Child}
Birth Date {2nd Child}*

MonthDayYear
Current school {2nd Child}*
Previous Jewish education (if applicable) {2nd Child}
Grade for 2024-2025 School Year {2nd Child}*
Would you like to register a third child?*

YesNo
Third Child Name*

First NameLast Name
Hebrew name (if applicable) {3rd Child}
Birth Date {3rd Child}*

MonthDayYear
Current school {3rd Child}*
Previous Jewish education (if applicable) {3rd Child}
Grade for 2024-2025 School Year {3rd Child}*
Would you like to register a fourth child?*

YesNo
Fourth Child Name*

First NameLast Name
Hebrew name (if applicable) {4th Child}
Birth Date {4th Child}*

MonthDayYear
Current school {4th Child}*
Grade for 2024-2025 School Year {4th Child}*
Previous Jewish education (if applicable) {4th Child}
This form can only accommodate 4 registrations. To register 5 or more, finish and submit this form and then fill it out again for additional children.

Authorizations, Waivers, & Payment info
Authorized Pickup Name

First NameLast Name
Authorized Pickup Phone Number
Please enter a valid phone number.
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship
Emergency Contact Phone Number*
Please enter a valid phone number.
Allergies or Health issues we need to be aware of*
If this is not applicable, write "None"
Is there anything else you'd like to share about you or your child/children?
Media Consent I give permission to the Jacksonville Community Kollel, and those authorized by the Jacksonville Community Kollel, to take photographs and to make recordings of my children and my family, and to use them in original or modified form in all media now or hereafter known, with or without my name or information about me, for the promotion, public education, and/or fundraising activities of the Jacksonville Community Kollel. Activities Consent My child has permission to engage in all programs and activities. Additionally, permission is hereby granted to the Jacksonville Community Kollel to take my child on trips outside of school as part of the regular school program. Medical Consent In the event that I cannot be contacted in an emergency or situation warranting medical attention, I hereby grant permission to The Jacksonville Community Kollel to bring my child/ren to the emergency room and/or give permission to the medical personnel selected by the program director to provide routine healthcare. Dismissal of Student The Jacksonville Community Kollel reserves the right to dismiss any student whose condition, conduct, influence or behavior is deemed unsatisfactory or detrimental to the best interest of the school, the student or their fellow students. In these instances, no refunds will be issued.*

AgreeDisagree
Acceptance and Payment

Submitting this form does not guarantee acceptance into the program. Applications are generally processed within 2-3 days. If your child\ren are accepted into Jewish Family Experience you will receive a welcome email with a link for payment.
JFE Tuition {Per Child}
We believe every Jewish child should be given access to an enriching Jewish education! No child will be refused enrollment due to inability to pay tuition. If you are unable to pay the above amounts, click below to request financial aid.
For questions regarding this form or the program please call Mrs. Freda Sanders at 404.242.5759 or e-mail fredasanders@jacksonvillekollel.com
Signature *

Clear
Agreement to the above consent form is required in order to proceed with the application.
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Jewish Family Experience Registration Form 2024-2025

Child's Information

This form can only accommodate 4 registrations. To register 5 or more, finish and submit this form and then fill it out again for additional children.

Parent Information

Authorizations, Waivers, & Payment info

Acceptance and Payment

For questions regarding this form or the program please call Mrs. Freda Sanders at 404.242.5759 or e-mail fredasanders@jacksonvillekollel.com

Agreement to the above consent form is required in order to proceed with the application.