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Programs & Classes JEMS @ The Shul

JEMS Registration

Gan Izzy Club Registration
We are currently accepting application forms for the 2026-2027 school year. Gan Izzy Club is a new program offered in 3 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*
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 - September 9Week 2 - September 16Week 3 - September 23Week 4 - September 30Week 5 - October 7Week 6 - October 14Week 7 - October 21Week 8 - October 28Week 9 - November 4Week 10 - November 11
Winter*

Week 1 - November 18Week 2 - November 25Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
Spring*

Week 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
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*
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 - September 9Week 2 - September 16Week 3 - September 23Week 4 - September 30Week 5 - October 7Week 6 - October 14Week 7 - October 21Week 8 - October 28Week 9 - November 4Week 10 - November 11
Winter*

Week 1 - November 18Week 2 - November 25Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
Spring*

Week 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
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*
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 - September 9Week 2 - September 16Week 3 - September 23Week 4 - September 30Week 5 - October 7Week 6 - October 14Week 7 - October 21Week 8 - October 28Week 9 - November 4Week 10 - November 11
Winter*

Week 1 - November 18Week 2 - November 25Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
Spring*

Week 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
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
Father's Occupation
Mother's Full Name*
Prefix First Name Last Name
Mother's Phone Number*
Mother's E-mail*
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Mother's Occupation*
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 $100 minimum deposit required at time of application

$
Total

$0.00

Payment

Credit Card Zelle

Postal / Zip Code

Country

Should be Empty:

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