Religious School - Form

* Parent/Guardian 1 First Name

* Parent 1 Last Name

Home Phone

* Parent 1 Email

Parent 1 Work Phone

* Parent 1 Cellphone

Parent/Guardian 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Work Phone

Parent 2 Cellphone

* Address line 1

Address line 2 (if needed)

* City/Town

* State

* ZIP

* Is P2 address same as P1 address?

YES (parents/guardians live togetherNO- parents do not live together (fill out Parent/Guardians 2's address, below)

Parent/Guardian 2 Address

Address line 2 (if needed)

* City/Town

* State

* ZIP

* Emergency Contact: Full Name

* Relationship

* Cell number

* Student 1 Name (First, Last)

* Hebrew name (ex. David ben Yisrael v'Sarah)

* Lives with?

* Date of birth

Student's email (if they have one)

Student's cell # (if they have one)

* School name

* Grade in school (as of Sept 2022)

* Any allergies or medical conditions we should know about (enter N/A if none)

* Please tell us any other information you feel we should know about (i.e. IEPs, special needs, etc.) (enter N/A if none)

Student 2 Name (First, Last)

Hebrew name (ex. David ben Yisrael v'Sarah)

Lives with?

Date of birth

Student's email (if they have one)

Student's cell # (if they have one)

School name

Grade in school (as of Sept 2022)

Any allergies or medical conditions we should know about (enter N/A if none)

Please tell us any other information you feel we should know about (i.e. IEPs, special needs, etc.) (enter N/A if none)

Student 3 Name (First, Last)

Hebrew name (ex. David ben Yisrael v'Sarah)

Lives with?

Date of birth

Student's email (if they have one)

Student's cell # (if they have one)

School name

Grade in school (as of Sept 2022)

Any allergies or medical conditions we should know about (enter N/A if none)

Please tell us any other information you feel we should know about (i.e. IEPs, special needs, etc.) (enter N/A if none)

There are many ways that you can contribute to the success of our Religious School program. Please check all areas in which you would like to participate (please check all that apply)

Room Parent (as needed)Board of Education (monthly meetings)Kosher Korner (purchasing snack food as needed)Fundraising (Mah Jongg, Box Tops, etc.)Teacher Appreciation Shabbat (shopping, set-up, clean-up)Shabbat DinnersLunch help

Is there another way you wish to offer help?

* From time to time, photos and videos of our students may be posted on our website, cable TV, or in newspapers. Students' full names are never included with their images. Please let us know if you give your permission for such images to be used

YesNo

* Is your family a member of B'nai Tikvah?

YesNo

* Authorization: By clicking here, I/we hereby register my/our child(ren) for the B'nai Tikvah Religious School

Authorization: By clicking here, I/we hereby register my/our child(ren) for the B'nai Tikvah Religious SchoolWithin a few days of registering, you will receive an invoice for the full tuition amount, per child, if applicable.
A $50 deposit (applied to that tuition) per child is required to hold their space in class.