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Menu
Watch Live
About Us
Belief and Practice
Community
Spiritual Leaders
Staff
Board
Membership
Life Cycle Events
Baby Naming and Brit Milah
Conversions
Weddings
End of Life
Yahrzeits
Calendar
Services
Shabbat
High Holy Days
Healing
Resources
Children
Minyan
Visit
Learn
Adult Education
Religious School
Early Childhood Center
Library
Bar/Bat Mitzvah
Volunteer
Shop
Give
Donate
Make a Payment
Funds
Religious School Registration Form 2024-2025
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Student's Name
*
First
Last
Hebrew Name
*
Date of Birth
*
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YYYY
2025
2024
2023
2022
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2020
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Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Current School (Fall 2024)
*
Current Grade (Fall 2024)
*
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
Ninth
Tenth
Student Email Address
Hebrew Lab (4th, 5th, and 6th Grade Only)
Students who attend Hasten Hebrew Academy of Indianapolis are exempt from Hebrew Lab.
Select your first choice for a Hebrew Lab time slot:
Tuesday 4 pm
Tuesday 5 pm
Wednesday 4 pm
Wednesday 5 pm
Wednesday 6 pm
Select your second choice for a Hebrew Lab time slot:
Tuesday 4 pm
Tuesday 5 pm
Wednesday 4 pm
Wednesday 5 pm
Wednesday 6 pm
Select your third choice for a Hebrew Lab time slot: (copy)
Tuesday 4 pm
Tuesday 5 pm
Wednesday 4 pm
Wednesday 5 pm
Wednesday 6 pm
Emergency Contact Information
Parent 1
*
First
Last
Cell Phone (home phone if no cell)
*
Parent 1 Email
*
Parent 2
First
Last
Cell Phone (home phone if no cell)
Parent 2 Email
If child lives in two homes, please include the second address below:
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Emergency Contact 1
*
First
Last
Relationship to Child
*
Phone
*
Emergency Contact 2
*
First
Last
Relationship to Child
*
Phone
*
Best method of contact on Sunday mornings?
*
Call
Text
Medical Information
Does your child have a pre-existing medical condition that might affect participation in Religious School activities?
*
Yes
No
If yes, please describe:
Is your child currently taking any medication?
*
Yes
No
If yes, please indicate name of medication(s), dosage, and medical condition:
Is your child allergic to any medications, foods, or environmental stimuli (e.g. bee stings)?
*
Yes
No
If yes, please explain below:
Media Release
We sometimes take photographs during Religious School activities and/or special events. Do you give permission for your child's photo to be used in synagogue communications (newsletters, e-mails, website, social media, etc.)
*
Yes
No
Signature
Typing your first and last name in this field serves as your signature for the entire form.
*
Submit