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Religious School Registration - 2022
Wednesday, June 1, 2022
•
2 Sivan 5782
6:00 PM - 7:00 PM
Register
Student Name
Date of Birth
Phone Number
Street Address
City:
Zip Code
Membership Status
Member of Neve Shalom
Not a member of Neve Shalom
Member of HPCT
Email
Child's Hebrew Name
Parents Name - Name #1
Parent's Name - Name #2
Parent's Hebrew Name - Parent #1
Parent's Hebrew Name - Parent #2
Parent #1 - Relationship
Parent #2 - Relationship
Parent #1 - Cell Phone
Parent #2 - Cell Phone
Parent #1 - Work Phone
Parent #2 - Work Phone
Emergency Contact - Name:
Emergency Contact - Phone
Child's Doctor
Child's Doctor's Phone Number:
Allergies to the following medicine(s):
Allergies to the following food(s):
My child regularly takes the following medications:
Identified learning or special needs:
Does your child have an IEP?
Yes
No
My child requires an Epi Pen which I will supply to the Religious School Director along with an allergy action plan.
Yes
No
In case none of the above can be reached, or it is imperative to treat the child without delay, I hereby give permission to the School Administration to take my child to the nearest hospital for medical treatment
Parent Signature:
Books and Materials Fees
Learn and Play the Jewish Way - Member ($25)
Learn and Play the Jewish Way - Non-Member ($30)
Kindergarten Through Seventh Grade - Member or Non-Member ($125)
8th through 12th Grade (0)
Tuition
Learn and Play the Jewish Way - Member ($150)
Learn and Play the Jewish Way - Non-Member ($225)
Religious School - K Thru 2nd Grade - Member - Tuition ($500)
Religious School - K Thru 2nd Grade - Non-Member - Tuition ($700)
Religious School - 3rd thru 7th Grade- Member ($950)
Religious School - 3rd thru 7th Grade- Non-Member ($1300)
Religious School - 8th thru 12th Grade- Member ($500)
Religious School - 8th thru 12th Grade- Non-Member ($850)
Total due for this child
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Fri, February 3 2023
12 Shevat 5783
Fri, February 3 2023 12 Shevat 5783