Religious School Registration Form 2023-2024 - Form

Thank you for registering for GJC Religious School, Teen Tuesday & Confirmation for the 2023-24 school year!

PLEASE COMPLETE YOUR ONLINE REGISTRATION BY JULY 31, 2023

REMINDER: You must submit a separate registration form for each student.

Student Information
Please note: You must fill out this form for each student you are enrolling in Religious School.

Student First Name

Student Last Name

Student Hebrew Name (Write in Hebrew or English)

Student Pronouns

Student Email (If Available)

Student Phone Number (If Available)

Date of Birth

2023-2024 Grade: Please Select a Grade from Below

2023-2024 Secular School

Special Needs and Additional Accommodations: GJC’s Religious School is proud of our diverse community of learners, and we do all we can to accommodate students with a variety of learning styles, needs and abilities. Please use the space below to share any information that you think will help your child thrive in Religious School. Please including any diagnoses or IEPs you'd like to share. Also, please feel free to call the Religious School office, in confidence, at 215-844-1507 x 24 if you wish to discuss this further.

Virtual Hebrew Learning for 2nd - 6th Grades
(If your child is not in 2nd-6th grade, please skip.)

Learning to read Hebrew is a core component of the GJC Religious School curriculum in grades 2, 3, 4, 5 and 6. Virtual Hebrew classes are taught online, to "chevruta" groups of 2 children, and held on Wednesday evenings. Please select the time slots that work best for your child to attend Virtual Hebrew. Please check ALL of the times that apply.

4:00-4:30 PM4:30-5:00 PM5:00-5:30 PM5:30-6:00 PM6:00-6:30 PM6:30-7:00 PM7:00-7:30 PM
NOTE: If it is impossible for your child to attend a virtual Hebrew lesson on Wednesday, please let Morah Abby (educator@germantownjewishcentre.org) know BEFORE AUGUST 1st.

Medical Information
Please see below for GJC's immunization requirements and other important information.

Allergies, Medication & Treatment Consent

Allergies: Please list any food, environmental, chemical, or animal allergies

Does your child require an EpiPen or emergency inhaler to be in the Religious School office or class room at all times?

Yes, my child requires an EpipenYes, my child requires an emergency inhalerYes, my child requires both an EpiPen AND an emergency inhalerNo, my child DOES NOT require an EpiPen nor an emergency inhaler

Please list any medications regularly taken, especially those that may need to be administered during RS hours:

Please list any medications that your child is required to carry and has permission to self-administer during Religious School hours.

Over the Counter Medication Consent: If appropriate, Germantown Jewish Centre Religious School has my permission to dispense acetaminophen (Tylenol), topical hydrocortisone or other OTC anti-itch treatment or topical antibiotic ointment or gel and band-aids to my child.

I AGREEI DO NOT AGREE

Emergency Treatment Consent: In the event your child becomes seriously ill during a school function, a reasonable effort will be made to (1) contact a parent or guardian, or, in their absence, (2) contact the alternate listed, (3) take or dispatch child to the nearest hospital emergency room. I hereby release Germantown Jewish Centre and its employees from any liability in case of an accident incurred during school hours. I understand that in case of illness, my child is covered by medical insurance, subject to the terms and conditions of my insurance plan. In case of emergency, I hereby give permission to the school to secure proper treatment for my child.

I AGREEI DO NOT AGREE

Immunization Record Requirement

Students attending GJC Religious School are required to be up to date on ALL immunizations as recommended by the CDC’s vaccination schedule. Students entering Kindergarten and 7th grade, and those who are new to GJC Religious School this year, are required to submit vaccination records to the Religious School office along with your registration. All records will be reviewed, and the Religious School office will follow up with any questions or concerns.

I am uploading below my kindergartner/7th-grader/NEW student's immunization records to GJC.I will email GJC my kindergartner/7th-grader/NEW student's immunization records to GJC by August 31, 2023.I believe GJC already has my child's updated immunization records from a previous year.

Yearly Flu Vaccination: All students attending GJC Religious School are required to receive the current year's flu vaccine and submit proof of flu vaccination by October 30, 2023.

I will ensure that my child receives the current year's flu vaccine and will submit proof of flu vaccination by October 30th.My child is unable to receive the current year's flu vaccine for medical reasons that I will describe below.

Please use this space to describe anything else about your child's physical or mental health that we need to know in order to help them thrive in Religious School.

Please upload your child's immunization documents here

Student Permissions

Photographs: I hereby give Germantown Jewish Centre Religious School permission to include photographs and/or video of my child/children for publicity/ educational purposes.

GJC Bulletin BoardsGJC Publications (Internal Newsletters, Emails)GJC WebsiteGJC & RS Social Media (Instagram, Facebook, etc.)

Dismissal Consent - SUNDAYS / SATURDAYS (Kindergarten-7th Grade)

My child will leave with parent ONLYMy child has permission to leave with the adults listed belowMy child has permission to leave GJC unaccompanied

Dismissal Consent - TUESDAYS (7th-10th Grade)

My child will leave with parent ONLYMy child has permission to leave with the adults listed belowMy child has permission to leave GJC unaccompanied

My child has permission to leave school with the following people:

We request that you let your child's teacher and Morah Abby know when your child will be missing school at least 48 hours before the class (Sundays or Virtual Hebrew) they will miss. The more notice the better!

Parent/Guardian Information

Parent 1 Name

Parent 1 Email

Parent 1 Address

Parent 1 Preferred Phone Number

Parent 2 Name

Parent 2 Email

Parent 2 Address (if different from Parent 1)

Parent 2 Preferred Phone Number

Emergency Contact Information

Emergency Contact 1 Name

Emergency Contact 1 Relationship

Emergency Contact 1 Phone Number

Emergency Contact 2 Name

Emergency Contact 2 Relationship

Emergency Contact 2 Phone Number

Tuition Payments for 2023-24

Below are the tuition rates for 2023-2024. Please select all of the tuition costs that apply to this student's registration.

Kindergarten and 1st Grade: $11752nd - 7th Grade: $18206th Grade - B’nei Mitzvah Mechinah Fee (added to the 6th grade RS tuition above): $5808th - 10th Grade (Teen Tuesday & Confirmation): $1200

NEW RS BILLING PROCEDURE:

Once you submit this registration, you will receive a bill for your RS tuition via email and US Mail. All bills will include:

RS Payment Plan Form -- Please include this form with your payment or use this form to communicate how you will pay for RS (credit card, ACH/bank transfer, check, etc...)
RS Scholarship Request Form - This is an optional form that any family can use to request financial assistance with your RS tuition.

Payments Plan & Scholarship Request forms are due back at GJC by SEPTEMBER 1st.

Enrollment is only verified once these forms are received.

EARLY BIRD DISCOUNT:
If you PAY IN FULL by SEPTEMBER 1, 2023, the following discounts will be applied to your bill:

2% discount on your total tuition if you pay by check or ACH
If you pay by credit card, GJC will waive the additional 4% credit card fee that would otherwise apply

REMINDERS:

Electronic RS Registration Forms are due July 31st.
You must submit a separate registration form for each student.

THANK YOU for filling out this form and for being a part of our GJC community!