2022-2023 KIDdish Registration Form

KIDdish is an introduction to Religious School for all Pre-K children ages 2-5 years old. This is a preschool class meeting on Sunday mornings where you can meet new friends and build budding Jewish relationships that can blossom for years to come.

$180 for the entire program. Open to the entire Jewish community! If you need a scholarship, please fill out the scholarship section of this form.

Opening day of KIDdish is Sunday, September 18, 2022

Full calendar coming soon.

Parent 1 Information

* First Name (Primary)

* Last Name (Primary)

* Relationship to Student(s)

* Email (Primary)

* Phone (Primary)

* Street Address (Primary)

* City (Primary)

* State (Primary)

* ZIP Code

Parent 2 Information

If there is a secondary contact, all emails and mailings will go to both contacts. In case of urgent need, the primary contact will be notified first

Is there a secondary parent or adult?

NoYes, at the same address as the primary contactYes, but at a different address than the primary contact

First Name (Secondary)

Last Name (Secondary)

Email (Secondary)

Phone (Secondary)

Relationship to Student(s)

Street Address (Secondary)

City (Secondary)

State (Secondary)

ZIP Code (Secondary)

Emergency Contact Information

In the event of an emergency, if the primary and/or secondary contact cannot be reached, we will contact this person.

* Emergency Contact First & Last Name

* Emergency Contact Phone Number

* Emergency Contact Relationship to Student(s)

Student Enrollment Information

* How many students are you enrolling in KIDdish?

Please note that there is a separate registration form for children attending our Religious School in grades K-7.

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

* Student 1 Allergies or Medications: Does your child have any serious allergies or medications we need to know about?

Student 1 Allergy/Medication Details

Please describe only allergies and medications we will need to be aware of during Religious School activities.

Student 2 Information

* Student 2 First Name

* Student 2 Last Name

* Student 2 Birthdate

* Student 2 Allergies or Medications: Does your child have any serious allergies or medications we need to know about?

Student 2 Allergy/Medication Details

Please describe only allergies and medications we will need to be aware of during Religious School activities.

Student 3 Information

* Student 3 First Name

* Student 3 Last Name

* Student 3 Birthdate

* Student 3 Allergies or Medications: Does your child have any serious allergies or medications we need to know about?

Student 3 Allergy/Medication Details

Please describe only allergies and medications we will need to be aware of during Religious School activities.

Student 4 Information

* Student 4 First Name

* Student 4 Last Name

* Student 4 Birthdate

* Student 4 Allergies or Medications: Does your child have any serious allergies or medications we need to know about?

Student 4 Allergy/Medication Details

Please describe only allergies and medications we will need to be aware of during Religious School activities.

Scholarship

Congregation Shomrei Torah is committed to providing Jewish education for our families. There are a limited number of partial scholarships supported by donations from members and others. Historically, scholarship awards have ranged from 10% to 50% of the tuition fee.

Are you requesting a scholarship?

NoYes

Please provide detailed information about your financial situation and your need for financial assistance.

Your request will be reviewed by the Religious School Scholarship Committee. This information is required to receive a scholarship and will remain confidential.

Medical Release

By signing my name below, my child(ren) have permission to participate in the KIDdish program of Congregation Shomrei Torah. I authorize Congregation Shomrei Torah staff to obtain emergency medical care for my child(ren) in the event such care is indicated. I understand that every effort will be made to notify a parent/guardian prior to treatment.

* By typing my name, I confirm I have read, understand and agree to the above.

Photo Release

* From time to time your child’s photo may be taken in our classrooms or special events. Images of your student(s) taken at KIDdish events might be published on the CST Facebook page, the CST website or the CST mailed publication "the VOICE". Children are never identified by name in publications. Do you give permission for your student to appear in these publications?

Pickup Information

OPTIONAL: The following adults (Other than the parents listed above) have permission to pick up my student:

Payment Information

Your $180 payment per student is due now to secure your student(s) spot. If you are unable to pay by credit card, you may bill this deposit to your account and send a check.

In order to bill this to your account, you must be a CST MEMBER and you must be LOGGED IN to your account. If you have never logged in or need instructions to get logged in to your account, click here.

Total Amount Due Today

The total amount due is $180 per student enrolled in KIDdish.

Thu, January 26 2023 4 Sh'vat 5783