Registration for All Child/Teen Programs at Kol Tikvah for 2023-2024
Please fill out this form if you are registering your child for Tikvah Kids (K-2), Tikvah Learning (grades 3-7), or Tikvah Teens (grades 8+). One form per child, please.

Please also complete this form if you would like to bring your little one (regularly or occasionally) to our free monthly Tikvah Tots play time (infant/toddler/pre-K); having your information will be helpful for us in our planning.

Tikvah Learning children only: Please remember that your child is expected to attend at least one Shabbat service per month during the school year

Tikvah Kids only: You may occasionally be asked to volunteer in your child's classroom

Everyone: Completing this form allows you to be included in our email distribution list to receive the Kol Tikvah newsletter and notices of upcoming events
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I am registering my child for:
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Child's full name (first/middle/last)
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Grade in 2023-2024
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Child's Hebrew name (write "none" or "unknown" if necessary)
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Child's date of birth
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MM
/
DD
/
YYYY
Child's allergies/relevant medical issues
Parent #1 NAME
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Parent #1 Mailing address
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Parent #1 Email
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Parent #1 Preferred phone number
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Parent #1 alternate phone number
Parent #2 NAME
Parent #2 Mailing address (if different from Parent #1)
Parent #2 Email
Parent #2 Preferred phone number
Parent #2 alternate phone number
EMERGENCY CONTACT PERSON #1 (other than parent)
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EMERGENCY CONTACT PERSON #1 - cell phone
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EMERGENCY CONTACT PERSON #2 (other than parent)
EMERGENCY CONTACT PERSON #2 - cell phone
The following people have permission to pick up my child:
Permission for my child to leave Kol Tikvah to walk/ride bike home alone
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Please let us know briefly of any learning issues, preferences, strategies, etc that would be helpful for our teaching staff to be aware of:
I give permission for Kol Tikvah to use photos of my child in promotional materials (website, newsletter, fliers). Full names will never be included.
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I understand that the program fee for Tikvah Kids ($300) and/or Tikvah Teens ($300) is due before the first session in September. For Tikvah Learning, the registration fee ($225 if paid by mid-June/$250 thereafter), with the program fee ($650) due before the first session in September.
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Public or private school my child will be attending during this year (helpful for us to know if carpooling is requested by anyone):
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