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Programs & Classes JEMS Gan Izzy Club

JEMS Gan Izzy Club Registration

Gan Izzy Club Registration
We are currently accepting application forms for the 2026-2027 club year. Gan Izzy Club is a new program offered in three 10-week sessions. Session 1 begins on Wednesday, September 9. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, feel free to contact Rabbi Yishai at 248-390-5711 or email [email protected].
How many children would you like to sign up?*
Child's Profile
Child 1
Child 1 Full Name*
First Name Last Name
Child 1 Hebrew Name
Child 1 Gender*

MaleFemale
Child 1 Birthdate*

Month Day Year
Born after sunset?* This is to help determine their Jewish birthday

YesNo
Child 1 School*
Child 1 Grade*
Which optional segments will you be joining in addition to the 1 hour Gan Izzy Club + Dinner?

5:00 - 5:30 PM: Homework help5:00 - 5:30 PM: Hebrew reading support6:30 - 7:00 PM: JewQ Competition
We will join*

Full Year ($350/child)1 session only ($150/session per child)Flexible ($20 per week)
My child is joining* $150/session per child

Fall Session (Sept 9–Nov 11)Winter Session (Nov 18–Feb 10)Spring Session (Feb 24–May 26)
Fall*

Week 1 - Sep 9Week 2 - Sep 16Week 3 - Sep 23Week 4 - Sep 30Week 5 - Oct 7Week 6 - Oct 14Week 7 - Oct 21Week 8 - Oct 28Week 9 - Nov 4Week 10 - Nov 11
Winter*

Week 1 - Nov 18Week 2 - Dec 2Week 3 - Dec 9Week 4 - Dec 16Week 5 - Jan 6Week 6 - Jan 13Week 7 - Jan 20Week 8 - Jan 27Week 9 - Feb 3Week 10 - Feb 10
Spring*

Week 1 - Feb 24Week 2 - Mar 3Week 3 - Mar 10Week 4 - Mar 17Week 5 - Apr 7Week 6 - Apr 14Week 7 - May 5Week 8 - May 12Week 9 - May 19Week 10 - May 26
Child 2
Child 2 Full Name*
First Name Last Name
Child 2 Hebrew Name
Child 2 Gender*

MaleFemale
Child 2 Birthdate*

Month Day Year
Born after sunset?* This is to help determine their Jewish birthday

YesNo
Child 2 School*
Child 2 Grade*
Which optional segments will you be joining in addition to the 1 hour Gan Izzy Club + Dinner?

5:00 - 5:30 PM: Homework help5:00 - 5:30 PM: Hebrew reading support6:30 - 7:00 PM: JewQ Competition
We will join*

Full Year ($350/child)1 session only ($150/session per child)Flexible ($20 per week)
My child is joining* $150/session per child

Fall Session (Sept 9–Nov 11)Winter Session (Nov 18–Feb 10)Spring Session (Feb 24–May 26)
Fall*

Week 1 - Sep 9Week 2 - Sep 16Week 3 - Sep 23Week 4 - Sep 30Week 5 - Oct 7Week 6 - Oct 14Week 7 - Oct 21Week 8 - Oct 28Week 9 - Nov 4Week 10 - Nov 11
Winter*

Week 1 - Nov 18Week 2 - Dec 2Week 3 - Dec 9Week 4 - Dec 16Week 5 - Jan 6Week 6 - Jan 13Week 7 - Jan 20Week 8 - Jan 27Week 9 - Feb 3Week 10 - Feb 10
Spring*

Week 1 - Feb 24Week 2 - Mar 3Week 3 - Mar 10Week 4 - Mar 17Week 5 - Apr 7Week 6 - Apr 14Week 7 - May 5Week 8 - May 12Week 9 - May 19Week 10 - May 26
Child 3
Child 3 Full Name*
First Name Last Name
Child 3 Hebrew Name
Child 3 Gender*

MaleFemale
Child 3 Birthdate*

Month Day Year
Born after sunset?* This is to help determine their Jewish birthday

YesNo
Child 3 School*
Child 3 Grade*
Which optional segments will you be joining in addition to the 1 hour Gan Izzy Club + Dinner?

5:00 - 5:30 PM: Homework help5:00 - 5:30 PM: Hebrew reading support6:30 - 7:00 PM: JewQ Competition
We will join*

Full Year ($350/child)1 session only ($150/session per child)Flexible ($20 per week)
My child is joining* $150/session per child

Fall Session (Sept 9–Nov 11)Winter Session (Nov 18–Feb 10)Spring Session (Feb 24–May 26)
Fall*

Week 1 - Sep 9Week 2 - Sep 16Week 3 - Sep 23Week 4 - Sep 30Week 5 - Oct 7Week 6 - Oct 14Week 7 - Oct 21Week 8 - Oct 28Week 9 - Nov 4Week 10 - Nov 11
Winter*

Week 1 - Nov 18Week 2 - Dec 2Week 3 - Dec 9Week 4 - Dec 16Week 5 - Jan 6Week 6 - Jan 13Week 7 - Jan 20Week 8 - Jan 27Week 9 - Feb 3Week 10 - Feb 10
Spring*

Week 1 - Feb 24Week 2 - Mar 3Week 3 - Mar 10Week 4 - Mar 17Week 5 - Apr 7Week 6 - Apr 14Week 7 - May 5Week 8 - May 12Week 9 - May 19Week 10 - May 26
Parents' Information
Parents' Status

MarriedDivorcedSeparatedWidowedSingle

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Father's Name
Salutation First Name Last Name
Father's Phone Number
Father's E-mail
Mother's Full Name*
Prefix First Name Last Name
Mother's Phone Number*
Mother's E-mail*
Is the natural mother of the child/ren Jewish?*

YesNoConverted
Were there any conversions or adoptions in the family?*

YesNo
Please explain:
CONFIDENTIAL: Does your child have any allergies, behavioral or other medical condition that we should be aware of? If yes, please describe them and indicate special precautions or care needed.
Please specify:
Payment Information
Payment method*

Pay full amount nowAlready discussed a payment plan with the Director
Total amount to be charged now

$
Total

$0.00

Payment

Credit Card Zelle

Postal / Zip Code

Country

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