Religious School Registration 2021-2022

Thank you for choosing Congregation Beth El Religious School for your child(ren) for the academic year for 2021-2022. We are very excited to return to in-person learning at our regular hours:
Sundays: 9:00am-12:00pm. ALL grades.
Wednesdays: 4:15-6:15pm. Bet-Vav.
We will follow COVID-19 protocols that are in place at the start of the school year. On behalf of the entire Beth El family, we look forward to another great year!

Please complete your Religious School registration form by August 1, 2021.

All outstanding balances must be paid before registering for the new school year. Please contact Laura at [email protected] with any questions or to arrange payment.

If you are in need of Financial Assistance for Religious School tuition, please use the link below to complete a Financial Assistance Application. Contact Cathy Backal at [email protected] with any questions.

BethElSNJ.payquiq.com/index.cfm

PLEASE NOTE:

1. Your child(ren)'s registration will only be accepted if you have selected a payment option and you are current with your payments to Congregation Beth El.

2. While we plan to return to in-person learning for the 2021-2022 school year, if your child requires special accommodations, please email or call Rabbi Marshall to discuss options at [email protected] or 856.675.1166 x419.

3. Please note that each student will be assessed a security fee. Students in Gan-Vav and Project Lev will be assessed a $50 security fee and students in Kibbitz & Kids will be assessed a $25 fee.

Family Information

* Family Name

* Home Phone Number

* Parent 1 Full Name

* Parent 1 Cell Phone Number

* Parent 1 Email Address

Parent 2 Full Name

Parent 2 Cell Phone Number

Parent 2 Email Address

* Are you a current member of Congregation Beth El?

Yes
No
We are considering joining, please send us more information about membership.

* Family Mailing Address

* Payment Plan Options

* Emergency Contact 1 Name

* Relationship to Child(ren)

* Emergency Contact 1 Phone Number

* Emergency Contact 2 Name

* Relationship to Child(ren)

* Emergency Contact 2 Phone Number

Student Information

* Child 1's Full Name

* Child 1's Full Hebrew Name

Please provide us with your child's full Hebrew Name which should include parents names. (Example for a Girl: Sarah Bat Yakov v' Razel; Example for a Boy: Moshe Ben Yakov v' Razel).

* Child 1's Date of Birth

Child 1's Gender

Male
Female

* Child 1's Grade- Fall 2021

* Public/Day School Child 1 Attends

* Child 1's Days of Attendance

Additional Information about Child 1 (Allergy, Medical, Educational Plans, etc.)

Please include any important information about your child (i.e. allergy information, important medical information, if your child has an I.E.P or 504 plan in public school). All information provided is strictly confidential and will only be shared with the BERS staff that will be working directly with your child.

Child 2's Full Name

Child 2's Full Hebrew Name

Please provide us with your child's full Hebrew Name which should include parents names. (Example for a Girl: Sarah Bat Yakov v' Razel; Example for a Boy: Moshe Ben Yakov v' Razel).

Child 2's Date of Birth

Child 2's Gender

Male
Female

Child 2's Grade- Fall 2021

Child 2's Days of Attendance

Public/Day School Child 2 Attends

Additional Information about Child 2

Child 3's Full Name

Child 3's Full Hebrew Name

Please provide us with your child's full Hebrew Name which should include parents names. (Example for a Girl: Sarah Bat Yakov v' Razel; Example for a Boy: Moshe Ben Yakov v' Razel).

Child 3's Date of Birth

Child 3's Gender

Male
Female

Child 3's Grade- Fall 2021

Child 3's Days of Attendance

Public/Day School Child 3 Attends

Additional Information about Child 3

Child 4's Full Name

Child 4's Full Hebrew Name

Please provide us with your child's full Hebrew Name which should include parents names. (Example for a Girl: Sarah Bat Yakov v' Razel; Example for a Boy: Moshe Ben Yakov v' Razel).

Child 4's Date of Birth

Child 4's Gender

Male
Female

Child 4's Grade- Fall 2021

Child 4's Days of Attendance

Public/Day School Child 4 Attends

Additional Information about Child 4

Parental Permission

* *Photographing of Children

Yes, my child(ren) may be photographed for both internal and external use (class projects, marketing, social media posts to the BERS & Congregation Beth El Facebook pages, etc.)
Yes, my child(ren) may be photographed, but only for internal uses (class project, etc.).
No, my child(ren) may NOT be photographed for any reason.

By signing electronically below, I give my permission to the Educational Director, Religious School Administrators, Rabbi, or person designated in charge to call an appropriate medical professional or to take my child(ren) to the hospital to receive appropriate emergency treatment in the case of an emergency and a parent/legal guardian cannot be reached.

* Parent/Guardian Signature

By signing electronically below, I authorize that the information provided in this registration form is correct and up-to-date. I am also authorizing this registration form to be processed.

* Parent/Guardian Signature

Account Details

Enter your name and e-mail address for your confirmation:

*E-mail

*First Name

*Last Name

Payment Information

Account

Online Fee:

Credit Card

Name on Card

Card Type

Card Number

Expiration Date

Card Verification Number

Address Line 1

City

State/Province

Zip

Comments

Increase the amount by 3% to cover credit card fees. Please select YES to increase your payment.

Total:

Religious School Registration 2021-2022

Family Information

Student Information

Parental Permission

Account Details

Enter your name and e-mail address for your confirmation:

Payment Information

Credit Card

Checking Account

For added Security please check the box below.

Religious School Registration 2021-2022

Family Information

Student Information

Parental Permission

Account Details

Enter your name and e-mail address for your confirmation:

Payment Information

Credit Card

Checking Account

For added Security please check the box below.

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