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2021-22 | 5782 Religious School Registration

Family Contact 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.

If unable to reach a parent or guardian, I authorize you to contact and release my child(ren) to the following persons:
Emergency contact needs to be someone other than parent/guardian

Provide the Doctor's name and number for each child.
Medical Release

By signing my name below, my child(ren) have permission to participate in the Religious School of Mishkon Tephilo. I hereby authorize the Director of the Religious School, or person designated by the Director of the Religious School, to obtain emergency medical care for my child(ren) in the event such care is needed. I give my permission for my child(ren) to receive emergency medical care by any nurse, doctor, paramedic or member of a medical staff of a hospital licensed by the State of California. I understand that every effort will be made to notify a parent/guardian prior to treatment.

I certify that my child(ren) is(are) in good physical health. My child(ren) have my permission to participate in all activities that are part of the regular Religious School program. 

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

By signing my name below, to certify that I have read a copy of the Family Handbook (click here to view). I understand that the handbook includes the School's schedule, philosophy, and goals, curriculum overview, programs that require my participation, School information and policies, as well as the Code of Student Behavior. I understand that School policy is established to create a well-organized, professional, and safe environment for my child(ren) and family.

By typing my name, I confirm I have read, understand and agree to the above.
Student Enrollment Information
Student 1 Information
Information will not be shared publicly. Parents will be copied on all communication to students.
Information will not be shared publicly. Students will not be contacted independently from parents.
Does your child have allergies, medical conditions, or medications we need to know about?
Please describe allergies, medical conditions, and medications with dosage and timing.
I have read, understand, and acknowledge the Mishkon Tephilo Religious School Vaccination Policy, found here.
My child is up to date with their vaccinations or has a medical exemption. If you answered no, a Mishkon Tephilo RS team member will contact you for more information. 
If yes, Ellie Laycook would love to have a conversation with you before the school year begins so that we are able to discuss the best ways to support your child. If you are comfortable we invite you to send any documentation ahead of time to Mishkon Tephilo.
Kindergarten-2nd Grade - Wednesdays 3:30-5:00 pm, 1st Sunday of the Month, and 3rd Saturday of the month

3rd Grade-7th Grade - Wednesdays 3:30-5:30 pm, 1st Sunday of the Month, and 3rd Saturday of the month
Teen Programming is offered on line Wednesdays 5-6pm and participate in Saturday and Sunday offerings. 
Please be advised that a variety of factors are taken into account when class groupings are determined. We appreciate your cooperation.
The Religious School Volunteer Parent Association (RSVP)  is very excited about the invigorated Mishkon Tephilo Religious School and the RSVP's role in supporting the RS. 

These funds  will be used to put in place several new programs including family and parent learning.  We will also use these funds for Chanukah and Year End presents for our incredible teaching staff.
Student 2 Information
Information will not be shared publicly. Parents will be copied on all communication to students.
Information will not be shared publicly. Students will not be contacted independently from parents.
Does your child have allergies, medical conditions, or medications we need to know about?
Please describe allergies, medical conditions, and medications with dosage and timing.
I have read, understand, and acknowledge the Mishkon Tephilo Religious School Vaccination Policy, found here.
My child is up to date with their vaccinations or has a medical exemption. If you answered no, a Mishkon Tephilo RS team member will contact you for more information. 
If yes, Ellie Laycook would love to have a conversation with you before the school year begins so that we are able to discuss the best ways to support your child. If you are comfortable we invite you to send any documentation ahead of time to ReligiousSchool@Mishkon.org.
Kindergarten-2nd Grade - Wednesdays 3:30-5:00 pm, 1st Sunday of the Month, and 3rd Saturday of the month

3rd Grade-7th Grade - Wednesdays 3:30-5:30 pm, 1st Sunday of the Month, and 3rd Saturday of the month
Teen Programming is offered on line Wednesdays 5-6pm and participate in Saturday and Sunday offerings. 
Please be advised that a variety of factors are taken into account when class groupings are determined. We appreciate your cooperation.
The Religious School Volunteer Parent Association (RSVP)  is very excited about the invigorated Mishkon Tephilo Religious School and the RSVP's role in supporting the RS. 

These funds  will be used to put in place several new programs including family and parent learning.  We will also use these funds for Chanukah and Year End presents for our incredible teaching staff.
Student 3 Information
Information will not be shared publicly. Parents will be copied on all communication to students.
Information will not be shared publicly. Students will not be contacted independently from parents.
Does your child have allergies, medical conditions, or medications we need to know about?
Please describe allergies, medical conditions, and medications with dosage and timing.
I have read, understand, and acknowledge the Mishkon Tephilo Religious School Vaccination Policy, found here.
My child is up to date with their vaccinations or has a medical exemption. If you answered no, a Mishkon Tephilo RS team member will contact you for more information. 
If yes, Ellie Laycook would love to have a conversation with you before the school year begins so that we are able to discuss the best ways to support your child. If you are comfortable we invite you to send any documentation ahead of time to elaycook@unisyn.org.
Kindergarten-2nd Grade - Wednesdays 3:30-5:00 pm, 1st Sunday of the Month, and 3rd Saturday of the month

3rd Grade-7th Grade - Wednesdays 3:30-5:30 pm, 1st Sunday of the Month, and 3rd Saturday of the month
Teen Programming is offered on line Wednesdays 5-6pm and participate in Saturday and Sunday offerings. 
Please be advised that a variety of factors are taken into account when class groupings are determined. We appreciate your cooperation.
The Religious School Volunteer Parent Association (RSVP)  is very excited about the invigorated Mishkon Tephilo Religious School and the RSVP's role in supporting the RS. 

These funds  will be used to put in place several new programs including family and parent learning.  We will also use these funds for Chanukah and Year End presents for our incredible teaching staff.
Student 4 Information
Information will not be shared publicly. Parents will be copied on all communication to students.
Information will not be shared publicly. Students will not be contacted independently from parents.
Does your child have allergies, medical conditions, or medications we need to know about?
Please describe allergies, medical conditions, and medications with dosage and timing.
I have read, understand, and acknowledge the University Synagogue Religious School Vaccination Policy, found here.
My child is up to date with their vaccinations or has a medical exemption. If you answered no, a UniSyn RS team member will contact you for more information. 
If yes, Ellie Laycook would love to have a conversation with you before the school year begins so that we are able to discuss the best ways to support your child. If you are comfortable we invite you to send any documentation ahead of time to elaycook@unisyn.org.
Kindergarten-2nd Grade - Wednesdays 3:30-5:00 pm, 1st Sunday of the Month, and 3rd Saturday of the month

3rd Grade-7th Grade - Wednesdays 3:30-5:30 pm, 1st Sunday of the Month, and 3rd Saturday of the month
Please be advised that a variety of factors are taken into account when class groupings are determined. We appreciate your cooperation.
The Religious School Volunteer Parent Association (RSVP)  is very excited about the invigorated Mishkon Tephilo Religious School and the RSVP's role in supporting the RS. 

These funds  will be used to put in place several new programs including family and parent learning.  We will also use these funds for Chanukah and Year End presents for our incredible teaching staff.
Learning Commitment

At Mishkon Tephilo we are committed to lifelong Jewish learning and aim to provide all students this foundation in childhood. In order to become Bnei Mitzvah at Mishkon Tephilo, we expect that students commit to enroll and attend a minimum of two years of Religious School as well as be enrolled during the year of their Bnei Mitzvah. Our Bnei Mitzvah students are additionally are expected to continue their Jewish education beyond their Bnei Mitzvah service. 

*Exceptions can be made with clergy and RS Director approval

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

From time to time your child’s photo may be taken in our classrooms or special events.  We use these photos in the synagogue newsletter (the Torch), on our synagogue display boards, the Mishkon Tephilo website as well as private Facebook groups and other publicity materials.

Congregation Community

You may have noticed that at the top of the form we begin with family information. This is intentional.  The work of raising and educating Jewish children cannot be done in the school alone, but is a project of the school, the family, and the community. You are not just registering your child(ren) for school today, but in fact your entire family. When you join our community and spend time learning and volunteering with us, you make a powerful statement to your child(ren) that Jewish learning is a lifelong process and that we are all on the same team in creating these experiences for them. Don’t underestimate the subtle power of this statement!

We have opportunities during the course of the year  on which parents are required to attend with students (Community Days - 3rd Saturdays and Tikkon Olam Events -1st Sunday of the month). Please plan to join us on these days.

In addition to those opportunities to participate we are in need of regular volunteers to make our school work.  Would you consider supporting our school in an ongoing role or a limited engagement?

Payment Information

In Jewish tradition, it is the job not only of parents but of the community to provide education for children. The Mishkon Tephilo community is committed to this obligation. As such, our religious school fee only covers a portion of the cost of our religious school. 

By writing my name below, I/we agree and understand that I am (we are) responsible for the agreed upon dues and tuition for the year of July 1, 2021 - June 30, 2022, and understand that due to necessary salary planning and budgeting for the year, the Synagogue does not prorate or offer refunds for dues, fees or tuition. I/we also agree that I/we must remain a member(s) in good standing, having fulfilled all financial commitments to Mishkon Tephilo in order to receive services including school attendance, High Holy Day tickets, and/or maintaining Bar/Bat Mitzvah dates.
By typing my name, I confirm I have read, understand and agree to the above.
Fri, March 29 2024 19 Adar II 5784