Religious School Registration Form 2024-2025

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Student's Name

First

Last

Hebrew Name

Date of Birth

Address

Address Line 1

Address Line 2

City

State

Zip Code

Current School (Fall 2024)

Current Grade (Fall 2024)

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:

Select your second choice for a Hebrew Lab time slot:

Select your third choice for a Hebrew Lab time slot: (copy)

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

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?

Is your child currently taking any medication?

Is your child allergic to any medications, foods, or environmental stimuli (e.g. bee stings)?

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.)

Signature

Typing your first and last name in this field serves as your signature for the entire form.