2024–25 Kesher and Nesiah Registration

Welcome to Kesher and Nesiah! The Kesher and Nesiah programs are generously sponsored by the Judith and Aaron z"l Alembik Ahavath Achim Youth Education Program.

To learn more about the programs, visit our webpage.

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2024–25 Youth Programming Calendar

A $300 non-fundable deposit per student will be collected after submission if payments will be made monthly or via alternate arrangement. This deposit will count toward tuition. (More information provided in the payment section at the end of this form).

Tuition for 2nd–6th grade students includes online Hebrew one day a week with the Atlanta Hebrew Connection. Unless you opt-out your child(ren) from the program, the cost is non-refundable. To register your child for Hebrew, click here.

Nesiah tuition includes the cost of the end-of-year trip (Sunday, June 1, 2025–Tuesday, June 2, 2025). It is non-refundable, and the date is subject to change.

Early Registration
Until Sunday, May 5

	Kesher PreK–1st Grade	Kesher 2nd–6th Grade	Nesiah 7th–9th Grade
Member	$850	$1290	$1400
Non-Member	$1250	$1690	$1800

Regular Registration
Monday, May 6–Sunday, June 30

	Kesher PreK–1st Grade	Kesher 2nd–6th Grade	Nesiah 7th–9th Grade
Member	$950	$1390	$1450
Non-Member	$1350	$1790	$1850

Late Registration
Monday, July 1–Saturday, August 17

	Kesher PreK–1st Grade	Kesher 2nd–6th Grade	Nesiah 7th–9th Grade
Member	$1050	$1490	$1550
Non-Member	$1450	$1890	$1950

Sibling Discounts

Enrolling two children: -$50
Enrolling three children: -$150
Enrolling four children: free tuition for fourth child/teen (to be reimbursed after payment)

If child(ren) enter(s) program after it begins, cost will be prorated.

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is there a second parent/guardian?*

YesNo

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Address (if different from first parent/guardian)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How many students are you registering?*

Student 1

Name*

First NameLast Name

Email*

example@example.com

Mobile Number*

Camp attended in Summer 2024 (if applicable)

School attending in Fall 2024*

Grade entering in Fall 2024*

Date of Bar/Bat Mitzvah (if applicable)

Please share any allergies or medical information that may be relevant to learning at Kesher and Nesiah (if none, write "N/A")*

If your child has an IEP of 504, please share what learning accommodations are made for this child (if none, write "N/A")*

Student 2

Name*

First NameLast Name

Email (if applicable)

example@example.com

Mobile Number (if applicable)

Camp attended in Summer 2024 (if applicable)

School attending in Fall 2024*

Grade entering in Fall 2024*

Date of Bar/Bat Mitzvah (if applicable)

Please share any allergies or medical information that may be relevant to learning at Kesher and Nesiah (if none, write "N/A")*

If your child has an IEP of 504, please share what learning accommodations are made for this child (if none, write "N/A")*

Student 3

Name*

First NameLast Name

Email (if applicable)

example@example.com

Mobile Number (if applicable)

Camp attended in Summer 2024 (if applicable)

School attending in Fall 2024*

Grade entering in Fall 2024*

Date of Bar/Bat Mitzvah (if applicable)

Please share any allergies or medical information that may be relevant to learning at Kesher and Nesiah (if none, write "N/A")*

If your child has an IEP of 504, please share what learning accommodations are made for this child (if none, write "N/A")*

Student 4

Name*

First NameLast Name

Email (if applicable)

example@example.com

Mobile Number (if applicable)

Camp attended in Summer 2024 (if applicable)

School attending in Fall 2024*

Grade entering in Fall 2024*

Date of Bar/Bat Mitzvah (if applicable)

Please share any allergies or medical information that may be relevant to learning at Kesher and Nesiah (if none, write "N/A")*

If your child has an IEP of 504, please share what learning accommodations are made for this child (if none, write "N/A")*

⭐ VOLUNTEER: Please help us strengthen our program(s) by selecting at least two volunteer opportunities in which to participate*

Serve on the Education Committee (help guide current and future programming)Volunteer at a holiday program (High Holidays, Sukkot, Chanukah, Purim, and/or Passover)Substitute for KesherCollect for teachers at the end of the year

⭐ SHARING CONTACT INFORMATION: May we share your contact information with other parents?*

YesNo

⭐ VACCINATIONS: Are your children up to date on school-mandated vaccines?*

YesNo

⭐ EMERGENCIES: As the parent/guardian of the child(ren) named above, I hereby give permission for the child to receive first aid, emergency medical transportation and emergency medical treatment (including x-ray examination, anesthetic, medical or surgical diagnosis) while in the care of Ahavath Achim Synagogue, its agents, volunteers and employees. I understand that I will be responsible for all costs incurred as a result of an emergency medical situation while my child is in the care of Ahavath Achim Synagogue, its agents, volunteers and employees.*

I give permission for my child/guardianship to receive treatment as stated above.I do NOT give permission for my child/guardianship to receive treatment as stated above.

⭐ PARTICIPATION IN YOUTH EDUCATION PROGRAMS AT AHAVATH ACHIM SYNAGOGUE: As the parent/guardian of the child(ren) named above, I grant permission for my child(ren) to participate in youth education programs at Ahavath Achim as part of the Kesher/Nesiah program. By signature below, I hereby voluntarily, knowingly, irrevocably and unconditionally release, acquit and forever discharge Ahavath Achim Synagogue, as well as each and all of its affiliates, subsidiaries, parents, predecessors, successors-in-interest, agents, partners, principals, officers, trustees, employees, advisors, coordinators, chaperones, volunteers, attorneys and their assigns from any and all claims, demands, damages, actions, causes of action, suits and liabilities of every kind and nature, arising out of, resulting from, or relating to any incidents that may occur during these programs, including but not limited to any bodily injury to such child(ren), to the fullest extent allowable by law.*

I agree with the above and give permission for my child/guardianship to participate in The Judith and Aaron z"l Alembik Ahavath Achim Youth Education Program.I do NOT agree with the above and do NOT give permission for my child/guardianship to participate in The Judith and Aaron z"l Alembik Ahavath Achim Youth Education Program.

⭐ TRANSPORTATION: I hereby grant permission to the adult staff members and volunteers of the Judith and Aaron z"l Alembik Ahavath Achim Youth Education Programs to transport my child in their personal vehicles on field trips.*

I agree with the foregoing and give permission for my child to be transported on field trips by an adult designated by the Judith and Aaron z"l Alembik Ahavath Achim Youth Education Program.I do NOT give permission for my child to be transported by anyone unless specifically designated by me on any of The Judith and Aaron z"l Alembik Ahavath Achim Youth Education Program field trips.

Authorized to pick up child: Please list full names, phone numbers, and relation of each person authorized to pick up your child from any of the Judith and Aaron z"l Alembik Ahavath Achim Youth Education Programs. *

⭐ PUBLICITY RELEASE: I hereby assign and grant Ahavath Achim Synagogue the right and permission to copyright and/or use and/or publish and republish photographic/video pictures and portraits of the minor named below in which said minor may be included in whole or in part, in color or black and white, made through any media by the photographer/videographer at his studio, at Kesher, Nesiah, or elsewhere, including the use of any printed matter in conjunction with such photographs. I hereby waive my right to inspect and/or approve the finished photograph or advertising copy, video, or printed matter that may be used in conjunction with such photographs/videos, or to the eventual use that it might be applied. I hereby release and discharge Ahavath Achim Synagogue, its assigns, and all persons acting under its permission or authority or those for whom it is acting, from and against any liability as a result of any distortion, blurring, alteration, or optical illusion that may occur in the taking of the picture/video or processing or reproduction of finished product. I hereby warrant that I am of full age and competent to contract for the minor named below in so far as the above is concerned. I have read the foregoing release and warrant that I fully understand the contents thereof.*

I agree to the above Publicity Release. I understand that I am giving permission for photographs, video tapes, and audio tapes of my child/guardianship to be made during Kesher/Nesiah activities and used for printed school publicity, posted to the school’s official website, Facebook page, and any public blogs.I do NOT agree to the above Publicity Release.

⭐ PARENT DIRECTORY: The Kesher/Nesiah parent directory will be given out to current parents at the school. Please choose which information you would like us to include:*

⭐ CARPOOL AND PICK-UP: I give my child permission at 12:30 pm on Kesher Sundays to:*

Check out without their adult present (meaning they can search for their ride in the building, but are not the responsibility of Kesher any more).Be checked out by an adult (The child is the responsibility of Kesher until an adult checks them out.)

Are you a member of Ahavath Achim Synagogue?*

YesNo

How many students are you enrolling in Kesher (Pre-K–1st Grade)?*

How many students are you enrolling in Kesher (2nd–6th Grade)?*

How many students are you enrolling in Nesiah (7th–9th Grade)?*

How many students are you enrolling in Kesher (Pre-K–1st Grade)?*

How many students are you enrolling in Kesher (2nd–6th Grade)?*

How many students are you enrolling in Nesiah (7th–9th Grade)?*

How many 2nd–6th grade students will opt out of the online Hebrew classes?*

Select "0" if all registered 2nd–6th graders will participate in the online Hebrew class.

Method of payment*

Credit CardCheck

How will you make your payments?*

In fullMonthly (a $300 deposit per student will be collected after submission)Pay 50% now and 50% in DecemberAlternate arrangement (a $300 deposit per student will be collected after submission)

SUBTOTAL 1

Student Discount

SUBTOTAL 2

Member Tuition

SUBTOTAL 3

Non-Member Tuition

SUBTOTAL 4

Online Hebrew

TOTAL 1

Subtotal 1 + Subtotal 2 + Subtotal 3 + Subtotal 4

TOTAL

Payment*

USDIncludes Convenience Fee (3% of Total)

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Someone will follow up with you soon regarding your deposit and remaining payment(s).

Checks should be made out to Ahavath Achim Synagogue and sent or delivered to Ahavath Achim Synagogue (600 Peachtree Battle Ave NW, Atlanta, GA 30327). Please write "Kesher/Nesiah" in the memo line.

Email for receipt*

example@example.com

Kesher and Nesiah Registration

Tuition Information

Parent/Guardian Information

Student Information

Other Information

Payment