Form Gesher/Nitzanim 2024-2025 Registration

This form is to register for Temple Israel's Religious School Gesher or Nitzanim programs for the 2024-2025 school year.

Please fill out all information fields below. More fields will become available once the original fields are completed.

Once your enrollment is received, it must be approved by the School staff. You will receive an email when this has been completed.

* Parent/Guardian 1 - First Name

* Parent/Guardian 1 - Last Name

* Parent/Guardian 1 - Email

* Parent/Guardian 1 - Mobile Phone

* Parent/Guardian 1 - Address

* Parent/Guardian 1 - City

* Parent/Guardian 1 - State

* Parent/Guardian 1 - Zip Code

Parent/Guardian 1 - Home Phone

* Is there a second parent/guardian?

* Parent/Guardian 2 - First Name

* Parent/Guardian 2 - Last Name

* Parent/Guardian 2 - Email

* Parent/Guardian 2 - Mobile Phone

* Does the second parent/guardian live at the same address as parent/guardian 1?

* Parent/Guardian 2 - Address

* Parent/Guardian 2 - City

* Parent/Guardian 2 - State

* Parent/Guardian 2 - Zip Code

Parent/Guardian 2 - Home Phone

* How many students are you registering for 2024-2025 school year ($725 per child)?

Please indicate if your child is registering for Gesher or Nitzanim

Gesher (Pre K - 4 year olds)Nitzanim (Kindegarten - 5 year olds)

Student 1 - First Name

Student 1 - Last Name

Student 1 - Gender

Student 1 - Hebrew Name

Student 1 - Birthdate

Student 1 - Grade as of September 2024

Student 1 - IEP

Does he/she have an IEP or special arrangements in Public School?

Student 1 - Allergies

Does this child have any allergies, medications, or food restrictions we should be aware of?

Total Amount

Student 2 - First Name

Student 2 - Last Name

Student 2 - Gender

Student 2 - Hebrew Name

Student 2 - Birthdate

Student 2 - Grade as of September 2024

Student 2 - IEP

Does he/she have an IEP or special arrangements in Public School?

Student 2 - Allergies

Does this child have any allergies, medications, or food restrictions we should be aware of?

PHOTO WAIVER

* Photo Waiver

Please Select OneYesNoI give Temple Israel permission to use photos of my child(ren) in its publicity such as in the synagogue bulletin, website, social media, and local newspapers, etc..

EMERGENCY CONTACT INFORMATION

Emergency Contact 1 - Name

In the event that we cannot contact you, what is the name of your family's emergency contact?

Emergency Contact 1 - Primary Phone

What is the first phone number we should try for this person if we cannot contact you?

Emergency Contact 1 - Alternate Phone

What is the alternate phone number, if any, for this contact?

Would you like to donate to our Parent Association?

Tuition alone only covers part of the costs of operating our Religious School. Support provided by the Religious School Parent's Association underwrites the costs of equipment, programs, and "special touches" for things which the budget doesn't allow us to address. Your PA dues truly enhance the quality and richness of our wonderful school! Thank you so much.

Sat, September 7 2024 4 Elul 5784