Kehillah Registration Form 2024-25

Kehillah Registration Form 2024-25
If you are a member of Congregation Beth Israel, Congregation Beth Yeshurun or Congregation Brith Shalom, do not fill out this form. Register directly through your synagogue.

If you are a member of another congregation or you are not affiliated with a congregation, please register for Kehillah High using the form below.
Student Name*

First NameLast Name
Preferred pronoun(s)*
Student Email*
example@example.com
Teen Cell Phone*
Please enter a valid phone number.
Student Date of Birth*

MonthDayYear
School*
Grade as of Fall 2024*

8th Grade9th Grade10th Grade11th Grade12th Grade
T-Shirt Size*

SmallMediumLargeX-LargeOther
Synagogue Affiliation*

YesNoOther
Which synagogue is your family affiliated?*
Allergies - food, environment, medical, etc. *
Current medications taking:*
Dietary needs:*
Please indicate gluten free, dairy free, etc.
Contact Information
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 1 Phone Number*
Please enter a valid phone number.
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Parent/Guardian 2 Email
example@example.com
Home Address 1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Address 2 (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payment Information

Tuition $995 per year per student.

Questions? Contact Danielle Alexander at dalexander@houstonjewish.org
Tuition can be paid all at once or on a scheduled payment plan.*

I will pay the rate of $995 in full by December 31 by credit card or eCheckI will set up recurring payments by credit card or eCheck.Other
Link for payment will be in your confirmation email.
Should be Empty:

Kehillah Registration Form 2024-25

Contact Information