2021-2022 Registration for Passport to Jewish Learning

Members

To ensure we receive your information, you must be logged into your account before registering. If you are not currently logged into your account, please log in before continuing.

Non-Members

Please email the office before continuing: I would like to Register for PJL

Program Overview Beyond COVID-19

Our 2021–2022 learning model will include in-person, Zoom, and family time learning to enhance our individual and collective Jewish journeys. Through a variety of hands-on experiences, students and their families will learn to question, problem solve, and build a more just world.

Please visit our Passport to Jewish Learning web page for a more detailed program overview. Please DOWNLOAD our calendar for class schedules and formats, events, and other opportunities for connection.

Tuition Commitment

Registration fee for the 2021-2022 school year is $50/child if registration is received by August 1st; $100/child if received after August 1st. Registration fee is due upon submission of registration form. Please note: 6th and 7th grade tuition does not include B'nai Mitzvah fees.

For scholarship information or to discuss special payment arrangements, please contact: Dawn Spector

* Congregation Rodef Shalom (CRS) membership:

CRS MembersCRS Non-Members

* Student 1 First Name

* Student 1 Last Name

* Date of Birth

* Registration Fee

Member Tuition

Non-Member Tuition

Current Grade

Student 1 Health and Individual Needs (check all that apply)

Learning or perceptualGross or fine motor skillsAttention deficit disorder with or without hyperactivitySpecial dietary needsMy child is taking regular medicationsBehavioral issues

Please explain physical conditions or illnesses, allergies, dietary needs, medications, behavioral issues, learning and social needs, including any information you would like to share to help us better understand your child(ren)'s educational and social needs.

Student 2 First Name

Student 2 Last Name

Date of Birth

Registration Fee

Member Tuition

Non-Member Tuition

Current Grade

Student 2 Health and Individual Needs (check all that apply)

Learning or perceptualGross or fine motor skillsAttention deficit disorder with or without hyperactivitySpecial dietary needsMy child is taking regular medicationsBehavioral issues

Student 3 First Name

Student 3 Last Name

Date of Birth

Registration Fee

Member Tuition

Non-Member Tuition

Current Grade

Student 3 Health and Individual Needs (check all that apply)

Learning or perceptualGross or fine motor skillsAttention deficit disorder with or without hyperactivitySpecial dietary needsMy child is taking regular medicationsBehavioral issues

(1) Emergency Contact First & Last Name

Relationship to Child(ren)

Phone Number

(2) Emergency Contact First & Last Name

Relationship to Child(ren)

Phone Number

Physician Name

Healthcare/Hospital or Emergency Facility

Phone Number

Parent Release Items

Emergency Release: In the event of an emergency, I hereby give permission to Congregation Rodef Shalom or its agent to hospitalize and/or secure proper treatment for my child(ren) as named in this form.Field Trip Release: I authorize my child(ren), listed in this form, to leave Congregation Rodef Shalom for Field Trips with adequate supervision and advanced notice.Photo and/or Video Release Authorization: Photos and/or videos will be taken of students, student activities, etc. Student names will not be used without a separate, signed release. I authorize the use of photos and videos of my child(ren), listed in

* Tuition Payment Method

* Tuition Payment Schedule

Please note: upon submitting this form, you will be taken to the online payment portal. If you are paying at a later date, paying with check, or requested help with payment method and schedule set-up, please select "Bill to my account" >> "Confirm and Continue" >> to ensure we receive your completed form.

Members

Non-Members

Program Overview Beyond COVID-19

Tuition Commitment

Today's Calendar

Friday Night

Shabbat Day

Upcoming Programs & Events

Fast of Tammuz

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