2025-2026 Religious School Registration

Non-Members are welcome to enroll children in preschool through grade 2 or in grades 9-12 for two years. There is an additional fee for doing so. If your children are in grades 3-8, please contact our Director of Learning, Abra Greenspan (abra@etzchayim.org) before completing this form. Below is a list of our fee structure for 2025-26.

How many children are you registering?

CHILD 1 INFORMATION

* Child 1 - First Name

* Child 1 - Last Name

Child 1 - Hebrew Name

Child 1 - Preferred Pronouns

* Child 1 - Birthdate

* Child 1 - Name of regular school

* Child 1 - Grade at Etz, 2025

* Child 1 - Grade in regular school, 2025

Child 1 - Student Email

NOT parent email address

Child 1 - Student Cell

NOT parent cell

Child 1 - To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Child 1 - Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.

CHILD 2 INFORMATION

* Child 2 - First Name

* Child 2 - Last Name

Child 2 - Hebrew Name

Child 2 - Preferred Pronouns

* Child 2 - Birthdate

* Child 2 - Name of regular school

* Child 2 - Grade at Etz, 2025

* Child 2 - Grade in regular school, 2025

Child 2 - Student Email

NOT parent email address

Child 2 - Student Cell

NOT parent cell

Child 2 - To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Child 2 - Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.

CHILD 3 INFORMATION

* Child 3 - First Name

* Child 3 - Last Name

Child 3 - Hebrew Name

Child 3 - Preferred Pronouns

* Child 3 - Birthdate

* Child 3 - Name of regular school

* Child 3 - Grade at Etz, 2025

* Child 3 - Grade in regular school, 2025

Child 3 - Student Email

NOT parent email address

Child 3 - Student Cell

NOT parent cell

Child 3 - To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Child 3 - Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.

CHILD 4 INFORMATION

* Child 4 - First Name

* Child 4 - Last Name

Child 4 - Hebrew Name

Child 4 - Preferred Pronouns

* Child 4 - Birthdate

* Child 4 - Name of regular school

* Child 4 - Grade at Etz, 2025

* Child 4 - Grade in regular school, 2025

Child 4 - Student Email

NOT parent email address

Child 4 - Student Cell

NOT parent cell

Child 4 - To help us provide the best learning experience for your child, please tell us about any social, physical, or emotional issues that may have an impact on your child's participation.

Child 4 - Please provide information regarding any allergies, food restrictions, medical conditions, or regular medications.

PARENT/GUARDIAN 1 INFORMATION

* First Name

* Last Name

* Email

* Mobile Phone

Home Phone

Work Phone

Child(ren) live with:

Please Select OneParent/Guardian 1Parent/Guardian 2Both

Address

City

State

Zip Code

Is there a second parent/guardian?

PARENT/GUARDIAN 2 INFORMATION

* First Name

* Last Name

* Email

* Mobile Phone

Home Phone

Work Phone

Address (if different from parent/guardian1)

City (if different from parent/guardian1)

State (if different from parent/guardian1)

Zip Code (if different from parent/guardian1)

EMERGENCY INFORMATION AND RELEASE

If my child has had a serious accident and neither parent nor emergency contact can be reached, I authorize Congregation Etz Chayim to secure proper treatment for my child, including ambulance service, at my expense.

I understand that my child may leave Etz Chayim premesis for supervised neighborhood walks during school hours.

* Insurance Carrier

* Insurance Phone Number

* Insurance ID# and all other required numbers

Please provide an additional emergency contact in the event that we are unable to reach a parent.

* Emergency Contact Name

* Emergency Contact Phone A

Emergency Contact Phone B

Emergency Contact Phone C

Total Tuition Fee

Fri, May 9 2025 11 Iyyar 5785

2025-2026 Religious School Registration

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