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2020-2021 Religious School Registration Form

Whether you are renewing your child(ren)'s Religious School membership or joining us for the first time, we are delighted you have chosen to be part of the Santa Monica Synagogue community this year. 

Please call upon us whenever we can assist you in becoming part of our Santa Monica Synagogue religious school community. Please call our office at 310.453.4276 if you have any questions or need assistance in filling out this form. All information in this form will be treated confidentially.


Parent 1 Information


Parent 2 Information


SCHOOL ENROLMENT INFORMATION
SCHOOL FEES
 

2020-21 School Tuition and Fees:       ($65 materials fee will be added to total)

  • $825 Children enrolled in K-3
  • $1550 Children enrolled in grades 4-7
  • $860 Children enrolled in grades 8-12
(includes materials fee)
EDUCATIONAL CONSIDERATIONS

In the text box(es) below, please note if your child(ren) receive(s) any education services, such as IEP, Adaptive Equipment, Special Education, Outside Tutoring, Physical / Occupational Therapy, One-on-on Aide*, Behavioral Resource, Gifted/Talented, etc.

 
MEDICAL INFORMATION
Please enter one or more names of people you authorize to pick up your child(ren) after school.
EMERGENCY CONTACT INFORMATION 
 

Please list two people that we may contact in the event we are unable to reach a parent in an emergency.

e.g. grandparent, aunt, family friend, etc.
e.g. grandparent, aunt, family friend, etc.

ADMINISTRATION
 

On the next page you will be presented with payment options.

You may make your payment by credit card, or choose to have it billed to your account so that you may make other arrangements, such as paying by check.

If you choose to pay by credit card, you may also specify if you wish to pay in full via a single payment, or via 2-12 monthly installments, right on the payment page.

IMPORTANT NOTE: If you wish to have your contribution billed to your account and wish to establish a multiple payment arrangement, please select Bill To My Account on the next page, and DO NOT change the payment amount/frequency.  You will then need to email bookkeeper@thesms to make your alternate payment arrangements.  We apologize for the inconvenience and are working to address this limitation.

By completing this form, I am affirming that all the information entered here is accurate and up to date, to the best of my knowledge.

PARENTAL CONSENT AND GENERAL RELEASE STATEMENT
 

I give permission for my child to participate in all of The Santa Monica Synagogue’s Religious School/Youth Group programs, activities and events and release The Santa Monica Synagogue and its representatives from all liability arising out of my child’s participation in such activities.

The Santa Monica Synagogue has my permission to obtain emergency medical treatment for my child when I cannot be reached or if a delay in reaching my child would be dangerous for him/her. I understand that I assume all financial responsibility for any treatment or injuries sustained by my child while he/she is in the care of The Santa Monica Synagogue.

I grant permission to The Santa Monica Synagogue to take photographs or videos of my child while my child is participating in The Santa Monica Synagogue activities, and for The Santa Monica Synagogue the right to edit, use, and reuse said photos/videos for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release The Santa Monica Synagogue from all claims, demands, and liabilities whatsoever in connection with the above.

 

Parent 's name(s)  (in lieu of e-signature)
Date
Includes all school registration fees.

Please click the 'Save and Continue' button below.

Tue, September 22 2020 4 Tishrei 5781