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Religious School Registration Form 2021-2022

Dear Families, Though September seems far away, plans are underway for an amazing school year and the teachers and we are really looking forward to welcoming your children back to Hebrew School in the fall! Please return the enclosed 2021-2022/5782 registration forms as soon as possible and help us provide your children with the best teachers and curriculum materials. This year, classes will begin September 19, 2021. After registering, If you are planning to bring the registration packet to the Temple on the first day of classes it is important to let us know about your plans and reserve a seat for your child/ren in the class of your preference. Please return the Registration Form to Alex Tansky at [email protected] as soon as possible. The Confidential and Permission Forms may be returned on the first day of classes. If you would like to discuss alternative financial arrangements, please contact Sandy Albert Executive Director at [email protected]. This is a very exciting time as we are moving forward at the Village Temple. and back to in person classes. I hope you and your family enjoy a refreshing summer and look forward to a great year of Jewish life and learning at the Village Temple! Please call 212-674-2340, ext. 308 or email at [email protected] with any questions you may have. B'shalom, Alex Tansky, R.J.E. Director of Education

Student 1

* Full Name

* Phone Number

* Address

* Date of Birth

Hebrew Name

Mobile

* Secular School

* Secular School Grade in Sept. 2019

Did your child attend a Summer Camp in 2019? Camp Name?

Did your child attend Summer Camp in 2018? Camp Name?

I am registering my child for Sunday class

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

I am registering my child for Tuesday Class

1st Grade

2nd Grade

3rd Grade

4th Grade

I am registering my child for Wednesday Class

5th Grade

6th Grade

7th Grade

Student 2

Full Name

Phone Number

Address

If differs from Student 1

Date of Birth

Hebrew Name

Mobile

Secular School

Secular school grade in Sept. 2019

Did your child attend a Summer Camp in 2019? Camp Name?

Did your child attend a Summer Camp in 2018? Camp Name?

I am registering my child for Sunday class

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

I am registering my child for Tuesday Class

1st Grade

2nd Grade

3rd Grade

4th Grade

I am registering my child for Wednesday Class

5th Grade

6th Grade

7th Grade

Student 3

Full Name

Phone Number

Address

If differs from students 1 or 2

Date of Birth

Hebrew Name

Mobile

Secular School

Secular school grade in Sept. 2019

Did your child attend a Summer Camp in 2019? Camp Name?

Did your child attend a Summer Camp in 2018? Camp Name?

I am registering my child for Sunday class

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

I am registering my child for Tuesday Class

1st Grade

2nd Grade

3rd Grade

4th Grade

I am registering my child for Wednesday Class

5th Grade

6th Grade

7th Grade

Parent/Guardian Information

Parent/Guardian 1

* Full Name

* Daytime Phone

* Home Phone

* Address

Fax

* Mobile

* Email Address

May we use email as a method of contact (class announcements, information etc.)?

Yes

Occupation

Employer

Parent/Guardian 2

Full Name

Daytime Phone

Home Phone

Address

Fax

Mobile

Email Address

May we use email as a method of contact (class announcements, information etc.)?

Yes

Occupation

Employer

Pick-Up Approvals

Name(s) of person(s) approved to pick your child(ren) up from school. Please indicate if your child(ren) have approval to walk home unattended or if there are any other special instructions.

My child(ren) can walk home unattended

Yes

Comments

Volunteer for YOUR Community!

We need YOU to help the Village Temple and its Religious School be the best congregation and Hebrew school for our families. Please write down any skills you have that you would be glad to share with the Temple community. We thank you for your help!

Permission Forms

PERMISSION FOR PHOTOGRAPHS AND PUBLICITY

I/We understand that my/our child(ren)’s likeness may be photographed or videotaped in an effort to inform the community of our unique Religious School programs and events. These images or videos (without names attached) may be used in school and community-wide publications, brochures, website, emails to members and non-members and other promotional media.

I/We Agree

I/We Do Not Agree

The Village Temple Religious School and Junior Youth Group

My son/daughter(s), have my permission to attend Religious School and Junior Youth Group Class Trips during the 2016-2017 school year. My child is in good physical health and does not have any physical disabilities which might be aggravated, unless otherwise noted below on this form, or placed in writing and attached.

I hereby authorize the Temple Educator, the Junior Youth Group Advisor, and other adult staff members, to act as my agents to consent to and/or to arrange any emergency medical treatment that may be deemed necessary by a physician, such as hospitalization, injection, anesthesia, or surgery, in the event that I cannot be reached in an emergency.

It is my understanding that all medical attention and/or health care needed, if necessary, in an emergency will be billed to me.

I/We Agree

I/We Do Not Agree

* Full Name of Child 1

Full Name of Child 2

Full Name of Child 3

Medical Insurance and Policy Number

Doctor's Name(s) and Phone Number(s)

Special Information, Allergies, Medications Taken

Please indicate by child

Class Schedule/Tuition Fees

In order to register your child for Religious School you must be a member in good standing of The Village Temple (except for Pre-K and Kindergarten). Membership forms are available from the Temple office or at www.villagetemple.org. Membership dues may be paid in the section under 'Membership Dues'.

2020-2021 CLASS SCHEDULES

Pre-K, Kindergarten Sundays 9:00am - 11:00am

Grades 1, 2 Sunday 9:00am - 11:00am

or Tuesday 3:45pm - 5:45pm

Grades 3, 4 Sunday 11:00am - 1:00pm

or Tuesday 3:45pm - 5:45pm

Grades 5, 6, 7 Sunday 9:00am - 1:00pm

or Wednesday 3:45pm - 6:00pm

2019-2020 TUITION FEES Please indicate number of children

Pre-K and Kindergarten

Grades 1 - 4

Grades 5-7

There is a $100 discount for each additional sibling

I am registering more then one child

Security badges will be sent to registered families, and will be required to drop off and pick up your child.

Beit Midrash / Madrich registration for grades 8-12 will be sent under separate cover.

Membership Dues

Dues

Family Dues $2,880.00

Single with Child(ren) $1,990.00

Security Fee

Security Fee $250.00

Confidential Information

Dear Village Temple Families,

We want to make sure that every child has a positive learning experience at the Village Temple Religious School. We need your help in creating the best possible classroom situation. Please take the time to answer the the following questions. This information can be of invaluable help to your child's teacher in trying to create the best learning environment for each student.

This information will be shared only with your child's teachers, the Rabbi and the Cantor/B'nai Mitzvah tutor.

If you have any questions, please give me a call at 212-674-2340, ext. 308.

Many thanks for your assistance.

B'Shalom,

Alex Tansky, R.J.E. Director of Education

Child 1

Name

Age and Grade

Allergies

Vision/Hearing Difficulties

Learning Strengths

Learning Difficulties

Special Gifts & Talents

Favored Learning Styles

Any other information which you think would help your child's learning

Child 2

Name

Age and Grade

Allergies

Vision/Hearing Difficulties

Learning Strengths

Learning Difficulties

Special Gifts & Talents

Favored Learning Styles

Any other information which you think would help your child's learning

Family

Are there any special religious issues at home?

In the case of divorced or seperated parents, please indicate with whom the student(s) live

How did you hear about The Village Temple?

Emergency Contacts

* Emergency Contact 1 Name

* Phone

* Relationship

* Cell

Emergency Contact 2 Name

Phone

Cell

Relationship

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E-mail

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First Name

Last Name

Payment Information

Account

Credit Card

Name on Card

Card Type

Card Number

Expiration Date

Card Verification Number

Address Line 1

City

State/Province

Zip

Checking Account

Name on the Account

Bank Name

Routing Number

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Account Number

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Confirm Account Number

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Comments

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