Religious High School Application 2023-24 - Form

Temple Solel - School of Living Judaism - HIGH SCHOOL - Registration Form

Confirmation preparation, trips, environmental and social action and opportunities for community service hours.

Grades Fees
Post B'nai Mitzvah - 12th grade Sundays, TBD $ No Charge

When completing this form, you will notice a red asterisk next to many of the questions. This means that an answer to the question is required. If you do not know the answer, please type "Unknown" and if the question does not apply to you, please type "Not Applicable."

* Child's - First Name

* Child's - Last Name

* Child's Gender

* Child's - Primary Address

* City

* State

* Zip Code

* Child Resides with

* Child 1 - Date of Birth

* Child's Grade- 2023-24

* Home Phone

Student's Email Address

* Primary Email Address

Has your child become a B'nai Mitzvah?

YesNo

If not at Temple Solel, please list where.

* Parent 1 - Name

* Parent 1 - Cell Phone

Work Phone

* Parent 1 - Email Address

* Parent 2 - Name

* Parent 2 - Cell Phone

Work Phone

* Parent 2 - Email Address

I am interested in volunteering during school hours

Yes - Parent 1Yes - Parent 2

* Are you a member of Temple Solel?

YesNo

Are you are a member of another synagogue, if so where?

Please write the name in the space above.

Emergency Contacts:

* Name (First, Last)

* Phone

* Relationship to your child

* Name (First, Last)

* Phone

* Relationship to your child

* Medical Insurance

* Phone

* Policy Number

* Physician's Name

* Phone

* Dentist's Name

* Phone

* Does your child have any allergies? If so, please list them in the box below.

* Does you child take any medication? If so, please list them in the box below.

* Is your child vaccinated against measles (MMR)?

YesNo

* Are your child's other vaccinations up to date?

yesNo

* Please include any important information about your child.

Pick-up Authorization

My teen will be driving his or herself to and from Temple Solel and other off campus activities.

YesNo

* Besides parent(s)/guardian(s), who else is authorized to pick up your child from school?

* Name (First, Last)

* Who is not permitted to pick up your child from school?

* Name (First, Last)

My family will attend and participate fully in the school program, unless otherwise agreed upon. We will arrive on time, stay until the end,and remain involved in the entire program, whether in person or online.
I understand that vandalism, disturbing the peace, or other inappropriate behavior, as determined by any teacher or member of the administrative staff, will not be tolerated. I understand that I will have to pay for any damage that is caused. I further understand that any such vandalism or inappropriate behavior could result in suspension or expulsion.
Temple Solel School programs may be photographed from time to time by our staff and media. Possible uses for these photos can include, but are not limited to: school projects, publication in editorial and promotional print materials, publication on Temple Solel’s web site, Facebook, and publication in newspapers, magazines, and other materials. By signing below, you agree that Temple Solel, its agents or assignees, and media outlets may use these photos, and that neither your child, nor you or your agents or assignees, will be entitled to any compensation for such uses.
I agree to have my child up to date on all usual pediatrician recommended vaccinations at time of attendance.

* I agree to the above and am registering my teen for the Temple Solel School of Living Judaism- High School Program

I agree to the above and am registering my teen for the Temple Solel School of Living Judaism- High School Program

Please type your name below

By typing my name I agree to the above and am registering my teen for the Temple Solel School of Living Judaism - High School Program

Date