TS/DBT Dharma School Registration 2023-2024

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Please register your child for the 2023-2024 Dharma School year.

Parent/Guardian Name *

Email Address *

Phone Number *

Address *

Parent/Guardian Birthday

YYYY

Second Parent/Guardian Name

Email Address

Phone Number

Address (if different)

Second Parent/Guardian Birthday

YYYY

Should the above information be used as the primary contact for your child or children?
*

Yes

If no, please list alternative primary contact.

Emergency Contact (different than already listed persons) Name, relation, phone number *

Are you a current Temple Member? *

Yes-Registration fee is $15 for the first child, $10 for any additional siblings

No- Registration fee is $25 for the first child, $20 for any additional siblings

Student's Name *

Date of Birth *

YYYY

Grade for 2023-2024 *

Allergies/ Medical Issues/ Accommodations Needed *

Student's Name

Date of Birth

YYYY

Grade for 2023-2024

Allergies/ Medical Issues/ Accommodations Needed

Student's Name

Date of Birth

YYYY

Grade for 2023-2024

Allergies/ Medical Issues/ Accommodations Needed

Permission to post photos *

Yes, I give permission to post photos and videos of my child(ren) on the TSDBT Facebook Page, Dharma School page and other closely monitored and related digital resources.

No, I Do not give permission to post pictures of my child(ren).

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