2023-24 Hesed Academy Registration - Form

Hesed Academy Tuition 2023 - 2024

Tuition
Kindergarten thru 3rd Grade $650 $240 for the remainder of the school year
Grades 4 thru 6 $780
Grades 7 - B'nai Mitzvah year $880
Aleynu- Grades 8-12 $360

Early Bird Discount: $36 per child in grades K-7. Enroll by August 10.

Scholarships
Scholarships are available. If you are interested in applying for a scholarship the application is available HERE. Students will not be turned away for financial reasons.

If you require Financial Aid, please see Section E (below).

* Is your family new to our school?

Please Select OneNoYes

Have you made your 2023-2024 CBI Membership Pledge?

Please Select OneYesNoWe encourage all our Hesed Academy Families to be members in good standing of CBI. You can see information about our pledge system and become a member HERE

Section A: Family Contact Information

* First Name (Primary)

* Last Name (Primary)

Relationship to Child

* Email (Primary)

* Mobile # (Primary)

* Street Address (Primary)

Street Address Line 2 (Primary)

* City (Primary)

* State (Primary)

* ZIP (Primary)

* Is there a secondary contact?

Please Select OneNoYes, at the same address as the primary contactYes, but at a different address than the primary contactIf 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

* First Name (Secondary)

* Last Name (Secondary)

Relationship to Child

* Email (Secondary)

* Mobile (Secondary)

* Street Address (Secondary)

Street Address Line 2 (Secondary)

* City (Secondary)

* State (Secondary)

* ZIP (Secondary)

Emergency Contact and Release Form

* Emergency Contact Name

* Emergency Contact Phone

* Emergency Contact Relationship

I authorize the following person(s) to pick up my child(ren) from Religious School

Section B: Student Enrollment Information

* How many Kindergarden - 8th grade children are being enrolled for the 2023-24 school year?

Please Select One1 Child2 Children3 Children

Student 1 Information

* Student 1 First Name

* Student 1 Last Name

* Student 1 Birthdate

Student 1 Hebrew Name

* Gender

(Male/Female/Non-Binary, Prefer not to Declare, etc.)

* Student 1 Grade in Religious School

* Student 1 Secular School Name & Grade This Fall

Student 1 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 1 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 1 Allergies, Medications or Other Medical Issues

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 1 Allergy/Medication/Other Medical Details

Please describe allergies and medications with dosage and timing.

Student 2 Information

Student 2 First Name

Student 2 Last Name

Student 2 Birthdate

Student 2 Hebrew Name

Gender

(Male/Female/Non-Binary, Prefer not to Declare, etc.)

Student 2 Grade in Religious School

* Student 2 Secular School Name & Grade This Fall

Student 2 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 2 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

* Student 2 Allergies/Medications or Other Medical Issues

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 2 Allergy/Medication/Other Medical Details

Please describe allergies and medications with dosage and timing.

Student 3 Information

Student 3 First Name

Student 3 Last Name

Student 3 Birthdate

Student 3 Hebrew Name

Gender

(Male/Female/Non-Binary, Prefer not to Declare, etc.)

Student 3 Grade in Religious School

Student 3 Secular School Name & Grade This Fall

Student 3 Email (if applicable)

Information will not be shared publicly. Parents will be copied on all communication to students.

Student 3 Phone (if applicable)

Information will not be shared publicly. Students will not be contacted independently from parents.

Student 3 Allergies, Medications or Other Medical Issues

Please Select OneNoYesDoes your child have allergies or medications we need to know about?

Student 3 Allergy/Medication/Other Medical Details

Please describe allergies and medications with dosage and timing.

Section C: Release Forms

CLASS TRIPS AND EMERGENCY MEDICAL TREATMENT RELEASE

By signing my name below, my child(ren) have permission to participate in the Hesed Academy at Congregation Beth Israel. In consideration of my child(ren)'s acceptance as a religious school student, I hereby waive any and all claims against Congregation Beth Israel, its agents, and its employees that may arise out of any injury, loss or damage suffered by my child(ren) during any religious school activity. I hereby authorize the Education Director, or person designated by the Education Director, to obtain emergency medical care for my child(ren) in the event such care is indicated. 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. They have my permission to participate in all activities that are part of the regular religious school program. Field trips may be arranged by Congregation Beth Israel, and transportation may include bus or vehicle driven by a classmate's parent or guardian.

* Medical Release: Enter your name below

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

* Date

PHOTO AUTHORIZATION AND RELEASE

I hereby expressly grant to Congregation Beth Israel and its employees, permission to photograph me and my children and use them in published material, or on the internet, television, or any other media now or hereafter known, for art, advertising, trade, or any other purpose connected with the marketing efforts of the school.

* Media Release

Please Select OneI grant permission for my and my child's image to be usedI do not grant permission for my or my child’s image to be used

* Date

PHONE BOOK RELEASE

We publish a list of names, addresses, and phone numbers of students in each class. We distribute the list to all Hesed Academy families.

Click Here if you DO NOT want your child(ren)'s Information Listed

Section E: Financial Aid

Do you require financial aid?

Please Select OneNoYesThere are many impediments to Jewish education but finances should never be one. We ask that every family commits to some financial contribution, however, we are very happy to discuss financial aid options for any member family that may require tuition assistance.

SCHOLARSHIPS
Scholarship applications are available HERE. Please submit no later than September 10, 2023.

Total Amount Due for This Year's Religious School

(non-refundable deposit will be deducted from this amount once received)