2024-2025 Temple Israel Religious School Registration - Form

We are so excited to have your family join the Temple Israel Religious School in 2024-2025.

Our first session is on Sunday, September 8, 2024. All students will attend sessions from 9:15 am to 11:30 am. Fourth through seventh graders have Hebrew after school until 12:30 pm. This year we will be offering after-care for younger siblings!

Section A: Family Contact Information

* First Name (Primary)

* Last Name (Primary)

* Email (Primary)

* Phone (Primary)

* Relationship to Student(s) (Primary)

* Street Address (Primary)

Street Address Line 2 (Primary)

* City (Primary)

* State (Primary)

* ZIP (Primary)

* Is there a secondary contact?

Please Select OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf there is a secondary contact, all emails and mailings will go to both contacts. In case of urgent need, the primary contact will be notified first

* First Name (Secondary)

* Last Name (Secondary)

* Email (Secondary)

* Phone (Secondary)

* Relationship to Student(s) (Secondary)

* Street Address (Secondary)

Street Address Line 2 (Secondary)

* City (Secondary)

* State (Secondary)

* ZIP (Secondary)

* Emergency Contact Name

* Emergency Contact Phone

* Emergency Contact Relationship

Section B: Student Enrollment Information

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

* Student 1 Hebrew Name

Student 1 Nickname (if applicable)

* Student 1 Grade in Religious School

Hebrew

* Student 1 Secular School Name

Student 1 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 1 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 1 Special Learning Needs

Please Select OneNoYes (IEP or 504 or similiar)

If yes, Education Director Dr. Jenn Levine would like to meet with you before the school year begins to discuss the best ways to support your child. We invite you to send any documentation ahead of time to drlevine@templeisraelalameda.org

* Student 1 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 1 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Student 2 Information

* Student 2 First Name

* Student 2 Last Name

* Student 2 Birthdate

* Student 2 Hebrew Name

Student 2 Nickname (if applicable)

* Student 2 Grade in Religious School

Hebrew

After Care

This year we are offering after-care for students who have siblings in the older grades who will be in Hebrew, in order to offer parents one pickup option. Please let us know if your K-3 child will need aftercare!

* Student 2 Secular School Name

Student 2 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 2 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 2 Special Learning Needs

Please Select OneNoYes (IEP or 504 or similiar)If yes, Education Director Dr. Jenn Levine would like to meet with you before the school year begins to discuss the best ways to support your child. We invite you to send any documentation ahead of time to drlevine@templeisraelalameda.org

* Student 2 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 2 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Student 3 Information

* Student 3 First Name

* Student 3 Last Name

* Student 3 Birthdate

* Student 3 Hebrew Name

Student 3 Nickname (if applicable)

* Student 3 Grade in Religious School

Hebrew

After Care

* Student 3 Secular School Name

Student 3 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 3 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 3 Special Learning Needs

Please Select OneNoYes (IEP or 504 or similiar)

* Student 3 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 3 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Student 4 Information

* Student 4 First Name

* Student 4 Last Name

* Student 4 Birthdate

* Student 4 Hebrew Name

Student 4 Nickname (if applicable)

* Student 4 Grade in Religious School

Hebrew

After Care

* Student 4 Secular School Name

Student 4 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 4 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 4 Special Learning Needs

Please Select OneNoYes (IEP or 504 or similiar)

* Student 4 Allergies or Medications

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 4 Allergy/Medication Details

Please describe allergies and medications with dosage and timing.

Section C: Release Forms

MEDICAL RELEASE: I HEREBY grant permission to Temple Israel of Alameda to call a physician for necessary medical care or hospitalization for my child in case of an emergency, after attempting to notify me first. In case of injury (if I/we are not available), I/we the undersigned parent(s) or legal guardian(s) of my child, do hereby authorize the personnel of Temple Israel of Alameda to administer necessary first aid and release the child to an emergency hospital or center for further treatment.

I give my child permission to attend any and all programs and field trips sponsored by Temple Israel of Alameda Religious School during the 2024-2025 school year. I understand and give permission for my child to be transported by bus, van, or car with staff and/or authorized parents. I hereby release Temple Israel of Alameda, their employees, and any designated agents from any and all liability in the case of accident or injuries incurred while traveling to, or participating in, programs and events sponsored by the Temple Israel both at the synagogue location and off-site. I understand that due caution and supervision will be provided at all times by Temple Israel of Alameda, its employees and agents.

Health Insurance Company Name, Phone Number and Insurance ID Number

* Medical Release: Enter your name below

By typing my name, I confirm I have read, understand and agree to the above.

Media Release

TEMPLE ISRAEL OF ALAMEDA MEDIA AUTHORIZATION: Many photos are taken during the school year, both at Temple Israel and during special events.

I authorize my child's photograph to be used in various Temple Israel publications, including, but not limited to, our synagogue website, social media sites, and other publicity materials. STUDENTS ARE NEVER IDENTIFIED BY NAME in any publicity.

* Media Release

Please Select OneI grant permission for my child's image to be usedI do not grant permission for my child’s image to be used

Section D: Congregation Community

You may have noticed that at the top of the form we begin with family information. This is intentional. The work of raising and educating Jewish children cannot be done in the school alone, but is a project of the school, the family and the community. You are not just registering your child(ren) for Temple Israel Religious School today, but in fact your entire family. When you come in the building and spend time learning and volunteering with us, you make a powerful statement to your children that Jewish learning is a lifelong process and that we are all on the same team in creating these experiences for them. Don’t underestimate the subtle power of this statement!

We welcome parents to connect with one another during snack time at 9:15 am (coffee and tea provided) and to join the community for prayer / tefillah at 11:10 am.

Additionally, we are in need of regular volunteers to make our school work. Would you consider supporting our school in an ongoing role or a limited engagement?

Any other skills or talents you might be willing to share?

Section E: Payment Information

* Do you need financial aid?

Please Select OneNoYesThere are many impediments to Jewish education but finances should never be one. Please do not hesitate to ask for help if you need it.

If you check "Yes" to financial aid, please select the option to charge the enrollment fee to your account when you submit this form. That way, the enrollment process completes without us receiving payment. After we confidentially discuss what you can reasonably contribute, our Children's Fund will help cover the rest of the tuition cost.

If you have questions, please contact President Kimberlee MacVicar president@templeisraelalameda.org

** Please note you need to have a 24-25 membership commitment on file. If you haven't completed a renewal for the 24-25 fiscal year please do so by going to the membership tab on the home page after you complete your registration.**

Total Amount