Sign In
Forgot Password
or Sign In With
Powered By
ShulCloud
Login
Home
Donate
Back To HJCNY
Donate
Calendar
Home
Donate
Religious School Registration 2024-2025
Please verify reCaptcha before submitting the form.
PARENT INFORMATION
*
Parent 1 First Name
*
Parent 1 Last Name
*
Parent 1 Email
*
Parent 1 Cell
Parent 1 Hebrew Name
Are you Jewish?
Jewish
Not Jewish
If you have questions about how to answer this question, Rabbi Rosin will be happy to discuss it with you. if you would like to speak with Rabbi Rosin please call the office at 631-427-1089 x 10 or at rabbirosin@hjcny.org.
Parent 2 First Name
Parent 2 Last Name
Parent 2 Email
Parent 2 Cell
Parent 2 Hebrew Name
Are you Jewish?
Jewish
Not Jewish
If you have questions about how to answer this question, Rabbi Rosin will be happy to discuss it with you. if you would like to speak with Rabbi Rosin please call the office at 631-427-1089 x 10 or at rabbirosin@hjcny.org.
*
Address 1 (Children)
Address 2 (Children)
*
City (Children)
*
State (Children)
--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
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip (Children)
*
Is either parent a member of Huntington Jewish Center?
Please Select One
Yes
No
*
How would you, as a parent/guardian, like to get involved. Please check at least one.
Sunday Bagel Committee
Purim Carnival
Religious School Committee
Class Parent
Holiday Help
Staff Gifts
EMERGENCY CONTACT(S)
*
How many emergency contacts would you like to add?
0
1
2
3
4
5
*
Contact 1 Name
*
Relationship to child(ren)
*
Cell
CHILD(REN) INFORMATION
*
Please select the number of children you are registering for religious school for the 2024-2025 school year?
0
1
2
3
4
5
6
7
8
9
10
*
Student First Name
*
Student Last Name
Gender
Please Select One
Female
Male
Other/Non-binary
*
Student Hebrew Name
*
Student Date of Birth
*
Grade Next September
Please Select One
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
*
School District (or name of school if private)
Food Allergies/Intolerances
Other Allergies/Medical Conditions
*
Does this child live at home with both parents?
Please Select One
Yes
No
*
If not, please explain:
Does this child have an IEP/504 plan/special learning needs/medical condition we should be aware of? If so please specify here.
Is there a situation at home that might impact attendance and/or participation in religious school? If so please explain here.
*
I give permission for this child's photo or likeness to appear in the Temple bulletin, local paper, or HJC social media pages:
Please Select One
Yes
No
*
I give permission for school authorities to take any action deemed necessary if I cannot be reached by telephone in case of emergency.
Please Select One
Yes
No
Please note that if you have a child entering 3rd grade, your registration will not be complete unless you are a synagogue member. Synagogue membership is required for children in 3rd grade and up. Please contact Rachel Gritz, in the Main Office to fill out a membership application at rgritz@hjcny.org or at 631-427-1089 x 23.
Total to be paid now
Thu, May 9 2024 1 Iyyar 5784