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Kadima Beth El Registration Form 2023-24

Registration Form 5784 / 2023-24

Welcome to the 5784 year at Kadima Beth El! We’re looking forward to all the possibilities!

Parent/Guardian Information

* Parent/Guardian 1 First Name

* Parent/Guardian 1 Last Name

Parent/Guardian 1 Pronouns

Please share your pronouns. Pronouns are the part of speech used to refer to someone in the third person. We want to know how to respectfully refer to you! Answers could include she/her, he/him, they/them, prefer not to say, etc.

* Parent/Guardian 1 Email

* Parent/Guardian 1 Phone

* Parent/Guardian 1 Relationship to Student(s)

* Parent/Guardian 1 Home Address

Home Address Line 2

* City

* State

* ZIP Code

* Is there a second parent/guardian?

If there is a secondary contact, all emails and mailings will go to both contacts, unless otherwise indicated.

* Parent/Guardian 2 First Name

* Parent/Guardian 2 Last Name

Parent/Guardian 2 Pronouns

* Parent/Guardian 2 Email

* Parent/Guardian 2 Phone

* Parent/Guardian 2 Relationship to Student(s)

* Can Parent/Guardian 2 be contacted about KBE information?

Parent/Guardian 2 Home Address

Home Address Line 2

City

State

ZIP Code

* Who should we contact during school hours?

Emergency Contact

* Emergency Contact First & Last Name

Please list someone other than parent(s)/guardian(s).

* Emergency Contact Phone Number

* Emergency Contact Relationship to Student(s)

Student Information

* How many students are you enrolling?

Are you a TBE member?

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthday

Student 1 Pronouns

Student 1 Email

If applicable.

Student 1 Hebrew Name

Please include parents' Hebrew names, if known.

* Student 1 Grade

* Student 1 Secular School Name

Student 1 Accommodations

Please provide accommodations for Student 1 (i.e. special physical, learning, behavioral, emotional needs, etc.)

Student 1 Medical Information

Please provide relevant medical information for Student 1 (i.e. medications, allergies, medical condition, etc.)

Student 1 Additional Information

Please provide any other relevant information about Student 1 you would like to share with us.

Student 2 Information

* Student 2 First Name

* Student 2 Last Name

Student 2 Birthday

Student 2 Pronouns

Student 2 Email

If applicable.

Student 2 Hebrew Name

Please include parents' Hebrew names, if known.

* Student 2 Grade

* Student 2 Secular School Name

Student 2 Accommodations

Please provide accommodations for Student 2 (i.e. special physical, learning, behavioral, emotional needs, etc.)

Student 2 Medical Information

Please provide relevant medical information for Student 2 (i.e. medications, allergies, medical condition, etc.)

Student 2 Additional Information

Please provide any other relevant information about Student 2 you would like to share with us.

Student 3 Information

Student 3 First Name

Student 3 Last Name

Student 3 Birthday

Student 3 Pronouns

Student 3 Email

If applicable.

Student 3 Hebrew Name

Please include parents' Hebrew names, if known.

Student 3 Grade

Student 3 Secular School Name

Student 3 Accommodations

Please provide accommodations for Student 3 (i.e. special physical, learning, behavioral, emotional needs, etc.)

Student 3 Medical Information

Please provide relevant medical information for Student 1 (i.e. medications, allergies, medical condition, etc.)

Student 3 Additional Information

Please provide any other relevant information about Student 3 you would like to share with us.

Student 4 Information

Student 4 First Name

Student 4 Last Name

Student 4 Birthdate

Student 4 Pronouns

Student 4 Email

If applicable.

Student 4 Hebrew Name

Please include parents' Hebrew names, if known.

Student 4 Grade

Student 4 Secular School Name

Student 4 Accommodations

Please provide accommodations for Student 4 (i.e. special physical, learning, behavioral, emotional needs, etc.)

Student 4 Medical Information

Please provide relevant medical information for Student 1 (i.e. medications, allergies, medical condition, etc.)

Student 4 Additional Information

Please provide any other relevant information about Student 4 you would like to share with us.

Can TBE use photos of the student(s) in print and/or online publications?

In addition to yourself (and the other parent/guardian, if applicable), these people have permission to pick up my child(ren):

Tuition Rate Schedule

Early bird deadline: Friday, July 14
Rates are listed below as: By July 14/After July 14

Please fill out for as many students as you are enrolling.

Select a Program for Student 1

Select a Program for Student 2

Select a Program for Student 3

Select a Program for Student 4

Tuition Rate Schedule

Please fill out for as many students as you are enrolling.

Select a Program for Student 1

Select a Program for Student 2

Select a Program for Student 3

Select a Program for Student 4

Scholarship Information

Need-based scholarship applications are available from the TBE office for member families. Allocations will be determined by our controller, Sherri Quint, by the end of August on a first come, first served basis.

Monthly payment plans are available.
Credit card or payment arrangement is due by the first day of classes.
Remaining tuition balance is due by Friday, December 22.

Like most Hebrew School programs, our school runs at a deficit and is supported by the congregation. Please consider making an additional donation to subsidize our programs, if you are in a position to do so. This makes it possible for us to provide quality education for everyone.

Kadima Beth El is grateful to the Jewish Community Alliance of Southern Maine for their ongoing support of our program.

The scholarship deadline is Friday, July 14.

* Please send me a scholarship application.

Deadline for application is Friday, July 14.

* Please contact me to set up a monthly or other payment arrangement.

* I would like to make an additional donation of $36 to help support KBE.

By signing my name below, my child(ren) have permission to participate in the religious school of Temple Beth El. I authorize Temple Beth El staff to obtain emergency medical care for my child(ren) in the event such care is indicated. I understand that every effort will be made to notify a parent/guardian prior to treatment.

* Release: Enter your name below

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

Thu, May 2 2024 24 Nisan 5784