Kol Yeladim Registration

* 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

Grandparent #1 Information

First Name

Last Name

Address

Phone

Grandparent #2 Information

First Name

Last Name

Address

Phone

Grandparent #3 Information

First Name

Last Name

Address

Phone

Grandparent #4 Information

First Name

Last Name

Address

Phone

Address

Section B: Student Enrollment Information

* Do you require financial aid?

Please Select OneNoYesThere are many impediments to Jewish education but finances should never be one! We ask that every family commits to some financial contribution, however we are very happy to discuss financial aid options for any family who needs it. If you select yes, you will discuss your payment ability in a confidential meeting with Rabbi Blatt.

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

* Student 1 Grade entering (August 2020)

Student 1 Nickname (if applicable)

Student 1 School Attending

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.

Is child attending Hillel Academy?

YesNo

* 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 Grade Entering (August 2020)

Student 2 Nickname (if applicable)

Student 2 School Attending

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.

Is child attending Hillel Academy?

YesNo

* 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 Grade Entering (August 2020)

Student 3 Nickname (if applicable)

Student 3 School Attending

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.

Is child attending Hillel Academy?

YesNo

* 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 Grade Entering (August 2020)

Student 4 Nickname (if applicable)

Student 4 School Attending

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.

Is child attending Hillel Academy?

YesNo

* 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

List of Names who can pick up child(ren)

The safety and well-being of all of our children is the main concern of Kol Yeladim Religious school. Please list below ALL PERSONS who have permission to pick up your child(ren) from religious school on Wednesdays and Sundays.

If for ANY reason a person who is not on the list below would have to pick up your child(ren), the religious school office must be notified by the parent before that day's pick-up. The parent should send a note to school with their child, or call the religious school office at (813) 960-3654, stating the name of the person who will be picking up the child(ren). Thank you for your cooperation as we strive to always do our best!

* School Pick-Up 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 newsletter (Chai Lites), on our synagogue display boards, the Kol Ami website as well as private Facebook groups and other publicity materials.

* I give my permission for my child(ren)'s photo to be used:

Please Select OneOn any materialsOn specific materials with my permissionI do not give my 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 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!

In addition to those opportunities to participate 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?

Ongoing Opportunities (check all that apply)

Youth Group (6-8th or 9th-12th) Chaperone

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

*Tuition*:
Pre-K		$350
Grades K-2		$555
Grades 3-7		$820
B’Nai Mitzvah Class (Kol Yeladim Students)		$820
Academy, Grades 8 & 9		$250
Confirmation Class		$310*
Academy, Grades 11 & 12		No Charge
*Book, Programming & Snack Fees*
Grades K-2		$120
Grades 3-6		$135
B’nai Mitzvah Class (Kol Yeladim Students)		$135*
*B'nai* *Mitzvah Class* *(Hillel Academy students)*		$425*

Monday - Thursday	8:30AM-5PM
Friday	8:30AM-3PM

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Congregation Kol Ami

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