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Online Religious School Registration
Student Information (click + to add more names)
Student's Name
Hebrew Name
DOB
Age
Gender
Grade in school this fall
Address
Street Address
City, State
Zip
Home Phone #
Legal Guardian 1 Information
Mother's Name
Cell # / Work #
Residence
Employer/Business Address
Email
Please indicate best number to reach you: home, cell, work, or other (specify)
Legal Guardian 2 Information
Father's Name
Cell # / Work #
Residence
Employer/Business Address
Email
Please indicate best number to reach you: home, cell, work, or other (specify)
If living arrangements of the child are not with Legal Guardian, please indicate with whom the child lives and their relationship to child:
Transportation: Persons authorized to pick up your child from Sunday School (click + to add more names)
Name
Address
Phone number
Emergency Contact Information
Emergency contact name
Relationship
Home #
Work #
Cell #
Consent
I acknowledge that I am responsible for keeping Congregation Ner Tamid’s Religious School advised of any significant changes in enrollment information concerning phone numbers, home addresses, email addresses, work locations, emergency contact, family physicians, etc.
Consent
I acknowledge that my child will be escorted by an adult into and out of the school at arrival and departure.
Consent
I understand that my child may be invited to participate in field trips and special activities away from the center, and I understand that I will be notified of these events in advance.
Consent
I agree to allow photos of my child to be used in Religious School and Congregation Ner Tamid publications and promotional materials.
My family‘s name, address, and phone number maybe used in a religious school directory to be disseminated to all students in the Religious School.
*
Yes
No
Please indicate the preferred email for school communication: Legal Guardian 1, Legal Guardian 2, or Both
I have reviewed the tuition rates and I will make arrangements with the CNT Finance Committee.
Are you interested in volunteering for the religious school?
Yes
No
Are you interested in being a substitute teacher for the religious school?
Yes
No
Please list special skills/talents you would be interested in sharing with our program:
If new to the CNT RS program, please describe any formal Jewish education your child has participated in.
If new to the CNT RS program, please describe any formal Hebrew language education your child has participated in.
*
Parent/Guardian 1 Name
Date
Parent or Guardian 2 Name
Date
Liability
The undersigned hereby agrees to release Congregation Ner Tamid’s Religious School, and its officers, employees, agents and servants from liability for any injury or loss of any kind that might be suffered by the undersigned, the children of the undersigned, or any other minors who are under the control of the undersigned, by way of guardianship or otherwise, where such injury or loss arises during or in any way in connection with, any field trip conducted by Congregation Ner Tamid’s Religious School, or it’s agents, officers or employees. The term “field trip“ as used herein shall include any activity of any sort, including the transportation of children or adults which occurs on property owned or leased by Congregation Ner Tamid’s Religious School. This release shall operate to bar liability for injury or loss resulting from any cause whatsoever, except in so far as such injury or loss results from the gross negligence of any employee of Congregation Ner Tamid’s Religious School.
Date
*
MM slash DD slash YYYY
*
Parent/Guardian 1
Parent/Guardian 2
BY SUBMITTING THIS ONLINE FORM YOU ACKNOWLEDGE THAT YOU HAVE READ AND AGREE TO THE TERMS OF LIABILITY AND CONSENT.
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