Please fill this form out only once per family. Congregation Beth Elohim Religious School 2008 – 2009 Registration Application Please complete both sides of this form and enclose registration fee. You MUST be a synagogue member in order to enroll your child in religious school. Father’s Name _______________________________ Mother’s Name _______________________________ E-mail Address ______________________________ E-mail Address ______________________________ Address ____________________________________ Address _____________________________________ ___________________________________________ _____________________________________________ Phone _____________________________________ Phone _______________________________________ Work Address _______________________________ Work Address ________________________________ _________________________________________       ___________________________________________ Work Phone ________________________________ Work Phone __________________________________ Cell Phone _________________________________ Cell Phone ___________________________________ Pager # ____________________________________ Pager # ______________________________________ Student(s) Name(s) ________________________________________________________________________ ______________________________________________________________________________ Our preferred mode of communication for general announcements and information is e-mail. Please let us know if you prefer not to use e-mail as the primary form of communication. Please contact me through: o Mother’s e-mail oFather’s e-mail oRegular mail In case of emergency, notify: Name ___________________________________________________ Phone _________________________ Name ___________________________________________________ Phone _________________________ Name ___________________________________________________ Phone _________________________ o Please attach your registration fee of $90 per child, with a maximum of $225 for 3 or more children. Check #: ________ Amount: ______ o Please include a photograph of your family which is intended to help the administrative staff better recognize all our families.     CBE PHOTO/VIDEO RELEASE FORM I hereby give my permission for images of my child(ren), captured during regular and special events at Congregation Beth Elohim through video, photo, and digital camera, to be used solely for the purposes of Beth Elohim related material and newspaper publications (internal and external). Name of Children _______________________________________________________ Name of Parent/Guardian (please print)______________________________________ Parent/Guardian’s Signature______________________________________ Date ______________________________________ Parent Volunteer Form We’ve all heard that "it takes a village" to succeed as a community.  This is indeed true for our synagogue community.  Not only would we love to have your help at the school, but your child would be so happy to see you volunteering at the synagogue.  Below you will find a list of specific tasks for which we anticipate needing help next year.  Please send this form back with a check next to a task that you feel is manageable. Todah, Thank you! Leann Shamash, Danya Bloomstone, Emily Navetta I can serve as a ___ Class Parent: Organize class Shabbat dinner with co-parents.  Guidelines are typed out and veteran parents are available as resources.  Time commitment is approximately 4 hours surrounding the date of the Class Shabbat Dinner. ___ Snack Organizer (K-3 only): Bring snack on first day of Sunday School in September.  Create and post sign-up sheet in classroom.  Assure that slots are filled and possibly provide an occasional back-up snack. I can help at Junior Congregation ___ I would like to provide a kiddush for Junior Congregation ___ I would like to be a "visiting scholar" and give a talk about the Torah portion Hebrew Read-athon ___ I would like to help out at this 1 hour school tzedakah project in January on Martin Luther King Day Sunday Purim Carnival ___ I can construct a booth for the carnival and/or work at the carnival Purim Shpiel ___ I am interested in participating in the Shpiel and/or its organization (January-March-Sunday morning commitment) ___ I would like to help write music for the Shpiel. ___ I would like to play music for the Shpiel. School Help (Time commitments vary.) ___ I would be willing to serve as a substitute teacher ___ I play a musical instrument and would be willing to play at the school ___ I would be interested in teaching a mini course in the high school ___ I would be interested in playing with our klezmer band ___ I am in the field of education and would be interested in helping with our teacher’s professional development. ___ I would be interested in leading an elective for our grade 3-7 students. (4x/year) Parent Name: ________________________________________________ Phone: _______________________ Children: Name: ________________________________________ Grade: ____________________                    Name: ________________________________________ Grade: ____________________                    Name: ________________________________________ Grade: ____________________ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Parent's Name____________________________________________________________________________                                 (Last)                                                                        (First) Student’s Name __________________________________________________________________________                                           (Last)                                                                        (First)                                                   (Middle) Date of Birth ____________________________ Hebrew Name _________________________________ Public School Grade ____________ Name of Public School __________________________                                   (as of 9/08) Previous Jewish Education _________________________________________________________________ With whom does student reside? ____________________________________________________________ Please indicate your session preference: Gan (Kindergarten) Sunday, 9 AM – 10:50 AM               Sunday, 11:10 AM – 1:00 PM  Aleph (First Grade) Sunday, 9 AM – 10:50 AM               Sunday, 11:10 AM – 1:00 PM  Bet (Second Grade) Sunday, 9 AM – 10:50 AM               Sunday, 11:10 AM – 1:00 PM  Gimel – Vav (Grades 3-6) Sunday, 9:00 AM – 10:50 AM and Tuesday 4:15 PM – 6:15 PM                                         Or Sunday, 11:10 AM – 1:00 PM and Wednesday 4:15 PM – 6:15 PM  Zayin (7 th Grade) Sunday, 11:10 AM – 1:00 PM and Wednesday 4:15 PM – 6:15 PM Midrasha (Grades 8-10) Monday, 6:30 PM – 8:30 PM  We will make every attempt to honor your request. However, we do need to consider class size, as well as coordination of sibling sessions, balance of total numbers, gender balance, fairness to families that have asked to be switched in the past and were not accommodated, and educational and/or social considerations. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - s Congregation Beth Elohim Religious School Authorization and Consent Form I understand that every effort will be made to contact me in the event of an emergency requiring medical attention for my child, ___________________________________. However, if I cannot be reached, I hereby authorize the staff of Congregation Beth Elohim Religious School to transport my child to the nearest emergency facility and to secure the necessary medical treatment for my child. Parent/Guardian Signature______________________________________  Date__________________     Congregation Beth Elohim Religious School 2008 – 2009 Registration Application It is in your child’s best interest that we have as much information as possible about him/her in the following areas. If circumstances change during the school year, please notify us. If you feel that further discussion is needed to better plan your child’s Jewish education, please arrange a confidential meeting with our Education Director. 1.) MEDICAL: A. Are there any medical issues or conditions about which we should be aware? Please explain or describe. If yes, are there any specific procedures that should be followed or should a specific person be consulted? ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ B. Does your child take any medications on an ongoing or regular basis? If so, please explain and provide any information that would be important for us to know vis-a-vis the medication and/or the condition for which the medication is prescribed.* ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ 2.) EDUCATIONAL: A. Does your child receive any specific academic support to optimize his/her learning experience? ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ B. Does your child have any specific learning strengths or weaknesses about which our staff should know? ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ 3.) Are there any social/emotional matters about which the staff or Educational Director should know to help make your child’s experience in our religious school successful? _________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ * If medication is taken to optimize the child’s learning or attention, it is encouraged that the same consideration be given to make the religious school experience as rewarding as possible.