HS Registration - Beth El Phoenix

* Is your family new to our school?

Please Select OneNoYes

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

* 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)

* 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

* 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)

* 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

* 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)

* 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

* 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)

* 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

By signing my name below, my child(ren) have permission to participate in the Hebrew School at Beth El Congregation. In consideration of my child(ren)'s acceptance as a religious school student, I hereby waive any and all claims against Beth El Congregation, its agents and its employees that may arise out of any injury, loss or damage suffered by my child(ren) during any religious school activity. I hereby authorize the Education Director, or person designated by the Education Director, to obtain emergency medical care for my child(ren) in the event such care is indicated. I give my permission for my child(ren) to receive emergency medical care by any nurse, doctor, paramedic or member of a medical staff of a hospital licensed by the State of Arizona. I understand that every effort will be made to notify a parent/guardian prior to treatment.

I certify that my child(ren) is(are) in good physical health. They have my permission to participate in all activities that are part of the regular religious school program.

* Medical Release: Enter your name below

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

Media Release

From time to time your child’s photo may be taken in our classrooms or special events. We use these photos in the synagogue newsletters, on our synagogue website as well as our Facebook groups and other publicity materials.

* 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

The work of raising and educating Jewish children cannot be done in our school alone, but is a project of the school, the family, and the Beth El community. You are not just registering your child(ren) for school today, but your entire family. When you come into the building and spend time learning and volunteering with us, you are affirming that Jewish learning is a lifelong process and that we are all on the same team in creating these experiences for them.

We have several days during the course of the year on which parents can participate in programs with our Hebrew School. We appreciate any and all volunteer time you can provide.

Are you interested in being contacted to help out with various volunteer opportunities throughout the year?

Ongoing Opportunities (check all that apply)

Room ParentSubstitute TeachingUSY-ChaperoneSocial-Action-Volunteer

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

* COVID-19 Protocol Release

COVID-19 Protocol ReleaseBy checking this box, I agree to follow all policies and procedures including those related to COVID-19 mitigation instituted by Beth El and its Hebrew School. Policies and procedures will be updated as the pandemic continues. The current policy will be provided to you on the first day of school and will be updated as needed.

Section E: Payment Information

Thank you for registering as a new family! Your student's first year of tuition is complimentary. A book fee of $75 per student will be added to your account once your registration is received and processed. Please contact our Hebrew School Director, Nanci Siegel Manson (nsiegelmanson@bethelphoenix.com or (602) 944-3359 ext. 123), if you have any questions prior to the start of Hebrew School. See you there!

Do you require financial aid?

Please Select OneNoYesThere are many impediments to Jewish education but finances should never be one. We are very happy to discuss financial aid options for any family that may require tuition assistance. If you select yes, you will be directed to discuss your payment ability confidentially with the Executive Director.
Please contact Executive Director, Alicia Moskowitz, at amoskowitz@bethelphoenix.com.

Financial Aid Follow-up: I understand and will contact Alicia Moskowitz

Total Amount

Please note: A book fee of $75 per student will be added to your account once your registration is received and processed.

Hebrew School Registration

Hebrew School Registration

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