TBS Religious School Registration 2022-2023/5783
Please fill out one registration form per student.
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Email *
Student First and Middle Name *
Student Last Name *
Name your child prefers to be called (nickname) *
Student Hebrew Name (if known)
Student Date of Birth *
MM
/
DD
/
YYYY
Student Grade in School *
Parent 1 First Name *
Parent 1 Last Name *
Parent 1 Hebrew name (if known)
Parent 1 Cell Phone *
Parent 1 Email Address *
Parent 1 Home Address *
Parent 2 First Name
Parent 2 Last Name
Parent 2 Hebrew Name (if known)
Parent 2 Cell Phone
Parent 2 Email Address
Parent 2 Home Address (if different from Parent 1)
Emergency Contact Name (if parent can not be reached) *
Emergency Contact Phone Number *
Emergency Contact Relationship to student
Emergency Contact Alternate Phone Number
Student's Elementary/Middle/High School *
School District *
Siblings (with ages)
Please list any conditions that require special attention at school (e.g., allergies, medical conditions, medication, etc.) *
Does your child have an IEP or other educational plan? *
May we have permission to photograph and publish your child’s picture? This includes on our Facebook Public page. *
Is there anything that you would like for us to know about your family? Please share here. *
For which class are you registering your child? *
Required
Payment Options
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Notes/Additional Comments:
To make a payment by credit card
Credit card payments may be made through our website:
http://tbshudson.org/duesfeesdonations
A copy of your responses will be emailed to the address you provided.
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