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Yom Shlishi, 3 Tammuz 5777

Religious School Registration

Shalom, Welcome!  We look forward to an exciting year here at CBS.  We are delighted that you are registering and look forward to greeting/meeting your children at the first day of school.  

If you have any questions or concerns, please contact the office at  office@cbsnapa.org

 

To register your children, please complete the registration form below.

After you have filled out the registration form, you will be re-directed to a page with payment information.  At that point, you may download the payment form (also available here), 
and return it to the office with a check OR you will also have the option of paying via PayPal 
(must pay for the year in full if using PayPal).

 

 

 


 

Page 1 of 6

2017-2018 Religious School Registration Form
  1. Please fill this form out for each child.

  2. Student Information

  3. Last Name:(*)
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  4. First Name:(*)
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  5. Gender:(*)
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  6. Birthdate:(*)

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    Click on the name of the month to move to a different month and year.
  7. Grade in Fall 2017(*)
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  8. Hebrew Name:
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  9. Day/Secular School:(*)
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  10. Student's Email Address:
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    If applicable. Parents will be copied on any emails sent directly to students.
  11. Student's Mobile Phone Number:
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  1. Emergency Contact Information

  2. Persons other than parents/guardians authorized to pick up child from school:(*)
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    Please list each person's name and primary phone number.
  3. Contact #1 Name:(*)
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  4. Contact #1 Phone Number:(*)
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  5. Contact #2 Name:(*)
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  6. Contact #2 Phone Number:(*)
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  1. Medical Information

  2. Physician:(*)
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  3. Physician's Phone Number:(*)
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  4. Dentist:(*)
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  5. Dentist's Phone Number:(*)
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  6. Medical Insurance Company:(*)
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  7. Medical Insurance Policy Number:(*)
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  8. Allergies:(*)
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    Please list any allergies your child has. If none, please list N/A.
  9. Please list any medications your child is taking:(*)
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    Please list all medications and frequency. If none, please list N/A.
  1. What are your goals for your child's Jewish education this year?
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  2. Does your child receive any special services in secular/day school? Does your child have an IEP or 504 plan?
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    Please explain any accommodations your child receives.
  3. Have there been any recent changes in home or school life that might affect your child's learning and engagement in Religious School?
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  4. Is there anything else you would like us to know about your child?
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  1. Parent Information


    You only need to fill out this section for one child.
  2. Child Lives With:(*)


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  3. Parent #1

  4. Last Name:
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  5. First Name:
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  6. Street Address:
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  7. City:
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  8. Zip Code:
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  9. Home Phone:
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  10. Mobile Phone:
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  11. Work Phone:
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  12. Email Address:(*)
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  13. Religious Affiliation:
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  14. Parent #2

  15. Last Name:
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  16. First Name:
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  17. Street Address:
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  18. City:
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  19. Zip Code:
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  20. Home Phone:
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  21. Mobile Phone:
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  22. Work Phone:
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  23. Email Address:
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  24. Religious Affiliation:
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  1. Volunteer

    You only need to fill out this section for one child.

    The Religious School at CBS needs your help! Jewish holiday celebrations are an important part your child’s learning experience. During class, the students learn the rituals, prayers, and meaning of the holidays. It’s after class that we come together as a community to celebrate with our children. These special events are organized and facilitated by the parents of the Religious School students.

    Please pick one event from the list below to help plan and two other events to assist with on the day of the event. Parents new to our school, don’t worry, you will have the support and guidance of the parents of the older students. Veteran parents, we rely on your wisdom and expertise. We couldn’t do it without you! The dates of the events are listed, so that you can mark your calendar now.

    • Sukkot, September 22 (this is a CBS event at Diamond Creek, during which there will be a one hour Sunday School program, for which we need parent volunteers)
    • Chanukah Fair - December 1, 2013
    • Tu B’shevat Tree Planting – January 12, 2014
    • Purim Carnival – March 16, 2014
    • Passover Celebration – April 13, 2014
    • End of the Year BBQ – May 18, 2014
    • Potluck and BBQ coordinator – ongoing
  2. I will help plan:






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  3. I would like to help plan this event with:
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  4. I will assist with (please select at least two events)






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