THE TEMPLE RELIGIOUS SCHOOL

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1 THE TEMPLE RELIGIOUS SCHOOL May 2015 / Iyar 5775 Dear Parents, I am extremely delighted and excited to share with you the registration materials for the Religious School year! This year we will begin school between the High Holy Days. The first day of Sunday School will be September 20 and Hebrew School (4th-6th grades) will begin the week of September 28 th. Our guiding Jewish value at the Temple Religious School is kehillah kedoshah- creating a holy community among our students, families and teachers. We want everybody in our congregation and our school to feel at home when they are here. We will have many opportunities and experiences throughout the year to build connections through learning, growing and having fun together. There s a catch though: we cannot do any of this alone. We believe that your partnership is essential in everything we do at the Temple. In order to raise children who are both knowledgeable and proud of being Jewish we must work as a team. The clergy and educational staff at the Temple are always available to answer questions, listen to feedback and work hard to ensure every child in our school is successful. There will also be dozens of opportunities for you to broaden and deepen your own connection to Judaism. Look for grade-level family programs, adult education classes, including Hebrew, as well as Shabbat and holiday family experiences throughout the year. Enclosed with this letter are the registration materials needed to enroll your child for the school year. Completed forms and a minimum of 1/3 of the total fees are due by July 1 with all the fees due by September 25. If you have questions about registration or our program, please do not hesitate to contact me at The Temple: or work phone: As we work together to create the highest quality learning experiences for our children, we look forward to a year filled with more connections, deeper understandings, laughter and joy. B shalom, with peace, Rabbi Michael Shulman, RJE Director of Education and Next Generation Programs

2 The Temple Religious School Registration Form Congregation Ohabai Sholom, 5015 Harding Road, Nashville, TN 37205, Phone: (615) FAMILY INFORMATION Family Name Family Home Phone Parent/Guardian #1 s Name Cell Phone Parent/Guardian #2 s Name Cell Phone IN CASE OF EMERGENCY Emergency Contact (other than above) Name Relationship to Family Phone MEDICAL AUTHORIZATION I authorize medical treatment of above minors when I cannot be contacted. Such medical treatment is to include, without limitation, x-ray examination, anesthetic, medical, dental or surgical examination or treatment and general hospital care. No prior determination of life-threatening emergency or danger of serious or permanent injury resulting from delay of treatment need be made under this authorization. Except as indicated at the end of this paragraph, this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power on the part of the adult to give specific consent to any and all such examinations, treatment or hospital care. (Exception: ) The possession of the original of this authorization by the adult is evidence that s/he has care and control of such minors and that I cannot be contacted. I will indemnify and hold harmless from any expenses or claims of any nature any entity which provides or causes to be provided examination, treatment or hospital care pursuant to this authorization (except to the extent such entity is negligent therein) and conditionally agree to make or cause to be made, by assignment of third party benefits or otherwise, full and complete payment for such examination, treatment or hospital care. I am the person having the power to consent to medical treatment of such minor. Parent's Name Phone Number Emergency Contact Phone Number Doctor's Name Phone Number Preferred Hospital Insurance Carrier Insurance # RELEASE FORM I give my permission for my child/ren to take trips with his/her class this year. I understand that the students will be supervised at all times. I give permission for my child/ren to take part in any and all authorized activities of the Religious School, including trips that may be made away from The Temple premises. I release the Religious School and The Temple, Congregation Ohabai Sholom and its agents and employees from any liability for any accident in connection with these activities other than as a result of gross negligence of the Religious School or The Temple, Congregation Ohabai Sholom and its agents and employees. I indemnify the Religious School and The Temple, Congregation Ohabai Sholom from any loss or liability they may incur as a result of any damages or injuries caused by the student. For insurance purposes, we are required to have on file your driver's license # State of Issuance. I carry Liability Insurance Yes or No (Please circle one) This authorization shall remain effective for a period of one (1) religious school year, unless sooner revoked by the physical destruction of the original hereof, such destruction being the only method of actual notice of the revocation of same. All blanks of this authorization were filled in before I signed this authorization. Signature Date Witness

3 STUDENT INFORMATION Student s Full Name Student s Nickname Grade Secular School Birthday Hebrew Name (if known) If Applicable: Student s Cell Phone Student s Address Summer Camp 2015 Medical and Other Information Some of this information will be shared on a need to know basis with Temple staff. Please be sure to keep us informed of any health changes and/or concerns that may arise throughout the year. Please describe your child s medical and/or dietary needs. (If none, please write N/A ) Please describe any learning or behavioral issues. This information will help us create a positive and meaningful experience for your child. (If none, please write N/A ) Is there anything else that you would like us to know? PLEASE COMPLETE ONE STUDENT INFORMATION FORM FOR EACH OF YOUR CHILDREN

4 STUDENT INFORMATION Student s Full Name Student s Nickname Grade Secular School Birthday Hebrew Name (if known) If Applicable: Student s Cell Phone Student s Address Summer Camp 2015 Medical and Other Information Some of this information will be shared on a need to know basis with Temple staff. Please be sure to keep us informed of any health changes and/or concerns that may arise throughout the year. Please describe your child s medical and/or dietary needs. (If none, please write N/A ) Please describe any learning or behavioral issues. This information will help us create a positive and meaningful experience for your child. (If none, please write N/A ) Is there anything else that you would like us to know? PLEASE COMPLETE ONE STUDENT INFORMATION FORM FOR EACH OF YOUR CHILDREN

5 The Temple Religious School Payment Form Family Name CALCULATION OF FEES Pre-K Parent-Child Program Sundays - Kindergarten 10 th Grade Midweek Hebrew - 4th 6th Grade Midweek 7 th Grade Program Post Confirmation $ per family $ per student $ per student $ per student $ per student Total $ Registration may be paid in 1 or 2 installments. Please indicate below. Apply my payment as follows: Payment 1 (Due with Registration forms by July 1) Minimum: 1/3 of total Payment 2 (Due September 25) $ $ If you need to make other payment arrangements, please contact Tammye Crump at The Temple. Pay by Check make checks payable to The Temple Religious School Pay by Credit Card continue with the next section IF PAYING BY CREDIT CARD ONLY 2.5% Convenience Fee (of Religious School fees) $ *A 2.5% convenience fee is added to offset bank fees if you are using your credit card for payment of school fees. Total Amount Due for Credit Card Users (Total Amount + 2.5% Convenience Fee) $ Please check which card you are using: Visa MasterCard AMEX Discover Credit Card # Expiration Date: Name (as it appears on the card) CVV Signature: Reoccurring Credit Card Payment In addition to paying my first payment by credit card, I hereby authorize The Temple to charge the above credit card in the amount(s) and date (s) listed below. Amount: Date: Signature: FINANCIAL ASSISTANCE The Temple s Religious School Scholarship Fund provides partial scholarships for families with financial need to help cover the tuition for our religious education programs. For more information and an application, please contact Rabbi Michael Shulman at The Temple.

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