Express JEMS @ The Shul Registration

JEMS @ The Shul 2021-22 begins on September 12 through May 22. We will operate on Sundays, from 10:30am-12pm (Optional Lunch n Learn free of charge -12-12:30 pm).

Child's Name 1*

First Name Last Name

Same school as last year & progressed grade?*

Yes No

If not, please specify

Are your child's immunizations up to date?*

Yes No

Changes in medical, behavioral or academic concerns

Child's Name 2

First Name Last Name

Same school as last year & progressed grade?

Yes No

If not, please specify

Changes in medical, behavioral or academic concerns

Are your child's immunizations up to date?

Yes No

Child's Name 3

First Name Last Name

Same school as last year & progressed grade?

Yes No

If not, please specify

Are your child's immunizations up to date?

Yes No

Changes in medical, behavioral or academic concerns

Father's Name*

First Name Last Name

Father's E-mail*

Mother's Name*

First Name Last Name

Mother's Email*

Same Address as last year?

Yes No

Same Parents cell numbers as last year?

Yes No

Same marital status as last year?

Yes No

If there are changes to any of the above questions, please enumerate

I hereby permit my child to participate in all school activities at The Shul Hebrew School and join in school trips on and beyond school properties. I permit The Shul Hebrew School to transport my child(ren) on school-provided transportation and to obtain emergency medical care as the situation mandates. I release The Shul and individuals from liability in case of accident during activities related to The Shul Hebrew School, as long as normal safety procedures have been taken. I allow The Shul Hebrew School to photograph and/or videotape my child(ren) to be used on the website, video & any other school related publications. I understand that my child may be dismissed during a school day, due to illness or unacceptable behavior, at the discretion of the school, and I agree to abide by the director’s decision. I understand that my $100 deposit is non-refundable and that the deposit is processed immediately. I understand that the deposit is non-refundable, after September 1 the tuition is non-refundable and that refunds will not be made for incomplete attendance. In addition, I understand that submitting a registration form and payment does not guarantee me a spot in school camp, and that acceptance into The Shul Hebrew School is at the discretion of the school.

The parent who signs the registration form represents that he/she has full authority to do so and will be responsible for payment of the school tuition.

Parent's Signature

Date

Month Day Year

Non-Refundable Deposit*

$100

Tuition Options*

Sponsor a Student -$1000 Full Tuition - $600 Subsidized Tuition - $550

Payment Plans*

Payment in full at time of registration Six equal monthly payments automatically charged on the first of the month from September through April

Discounts Check all that apply

10% Additional Child Discount 25% New Student Discount

Total charged now

$0.00

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

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JEMS @ The Shul
Jewish Education Matters

Express JEMS @ The Shul Registration

EXPRESS HEBREW SCHOOL REGISTRATION

Child 1

Child 2

Child 3

Parents Information

Permission

Tuition

More in this section

JEMS @ The ShulJewish Education Matters

EXPRESS HEBREW SCHOOL REGISTRATION

Child 1

Child 2

Child 3

Parents Information

Permission

Tuition

More in this section

JEMS @ The Shul
Jewish Education Matters