Hebrew School Registration
Please fill out the form for the 2024-2025 school year
Child's Name
*
First Name
Last Name
Child's DOB
*
-
Month
-
Day
Year
Date
Child's Gender
*
Child's Grade in School
*
Child's Hebrew Name
*
Add Another Child?
*
Yes
No
Child's Name
*
First Name
Last Name
Child's DOB
*
-
Month
-
Day
Year
Date
Child's Gender
*
Child's Grade in School
*
Child's Hebrew Name
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent Name(s)
*
Parent Email(s)
*
Parent Phone Number(s)
*
Synagogue Affiliation
*
Adath Jeshurun Synagogue
Congregation Emet V'Or
Rodef Sholom Temple
Temple Beth El
Temple Sinai
Not Affiliated
Other
Medical or Custody Concerns (kept confidential)
Emergency Contact (Name, Phone Number, Address, Relationship to Child)
*
Submit
Should be Empty: