Kehal Kodesh Religious School Registration 21/22 - Form - Kehal Kodesh Bene Israel Rockdale Temple

Kehal Kodesh Religious School at Rockdale Temple
Annual Registration Form

Please complete this registration form each year so that we have updated information for your child(ren). Contact the Rockdale Temple office with any issues with the form (513-891-9900 or padkins@rockdaletemple.org). Thank you!

PARENT/CAREGIVER INFORMATION

* Parent/Caregiver 1 First Name

* Last Name

Pronouns

* Email

* Cell Number

If your pronouns are not shown on the list above, please list them here if you are comfortable doing so.

* Home Address:

* City:

State:

* Zip:

Parent/Caregiver 2 First Name

Last Name

Pronouns

Cell Number

If your pronouns are not shown on the list above, please list them here if you are comfortable doing so.

Home Address

If different from above

City:

State:

Zip:

How many students will you be registering for Kehal Kodesh Religious School?

STUDENT INFORMATION

Name of Student 1

Preferred Name

What does your student preferred to be called?

Student 1 Pronouns

Student 1 Birth Date

If the student's pronouns are not shown on the list above, please list them here if you are comfortable doing so.

Public/Private School attending as of 2020-21 school year:

Grade:

Student 1 email address:

For Tuesday Hebrew School, would you prefer one-on-one tutoring in-person or online?

In-person at Rockdale TempleOnline

Is there any information which your would like to share with Assistant Rabbi and Educator, Erin Binder, Student Support Specialist Dani Reiss, and your student's teacher that will be helpful in addressing your student's needs (medical, behavioral, learning, etc.)?

YesNoIf you check yes, we will contact you prior to the start of the school year for a confidential conversation.

If there is any information you'd like to share here in writing, please do so in the space provided (we will still contact you if you've indicated you'd like to speak with us).

Does this student have any food allergies/sensitivities, environmental allergies, or medical conditions? Please provide details below.

Name of Student 2

Preferred Name

What does your student prefer to be called?

Student 2 Pronouns

Student 2 Birth Date

If the student's pronouns are not shown on the list above, please list them here if you are comfortable doing so.

Public/Private School Attending as of the 2021-22 school year:

Grade:

Student 2 email address:

For Tuesday Hebrew School, would you prefer one-on-one tutoring in-person or online?

In-person at Rockdale TempleOnline

YesNoIf you check yes, we will contact you prior to the beginning of the school year for a confidential conversation.

If there is any information you'd like to share here in writing, please do so in the space provided (we will still contact you if you've indicated you'd like to speak with us).

Does this student have any food allergies/sensitivities, environmental allergies, or medical conditions? Please explain.

Name of Student 3

Preferred Name:

What does your student prefer to be called?

Student 3 Pronouns

Student 3 Birth Date

If the student's pronouns are not shown on the list above, please list them here if you are comfortable doing so.

Student 3 email address:

Public/Private School attending for the 2020-2021 school year

Grade:

For Tuesday Hebrew School, would you prefer one-on-one tutoring in-person or online?

In-person at Rockdale TempleOnline

YesNoIf you check yes, we will contact you prior to the start of the school year for a confidential conversation.

If there is any information you'd like to share here in writing, please do so in the space provided (we will still contact you if you've indicated you'd like to speak with us).

Does this student have any food allergies/sensitivities, environmental allergies, or medical conditions? Please explain.

Name of Student 4

Preferred Name

What does your student prefer to be called?

Student 4 Pronouns

Student 4 Birth Date

If the student's pronouns are not shown on the list above, please list them here if you are comfortable doing so.

Public/Private School attending as of 2020-21 school year:

Grade:

Student 4 email address:

For Tuesday Hebrew School, would you prefer one-on-one tutoring in-person or online?

In-person at Rockdale TempleOnline

For Tuesday Hebrew School, would you prefer one-on-one tutoring in-person or online?

In-person at Rockdale TempleOnline

YesNoIf you check yes, we will contact you prior to the start of the school year for a confidential conversation.

If there is any information you'd like to share here in writing, please do so in the space provided (we will still contact you if you've indicated you'd like to speak with us).

Does this student have any food allergies/sensitivities, environmental allergies, or medical conditions? Please explain.

Please fill out the following items.

IN CASE OF EMERGENCY

* In case of emergency, please notify (person other than parents/guardians):

* Emergency contact phone number:

* Preferred Hospital:

Physician's Name:

Physician's Phone Number:

* Do you give consent for emergency medical treatment of your child(ren)?

YesNo

Please explain what you wish school authorities to do if you elected not to give consent for emergency medical treatment.

Planning for a Great Year at Kehal Kodesh!

Please contact me regarding the following volunteer opportunities:

School Holiday ProgramsSupplies-Delivery-SupportReligious School CommitteePhotography/Videography of Special Events

I give permission for Rockdale Temple to use photos and recordings from Religious School programs online and in future communications including print and social media for promotion of and education about Rockdale Temple.

YesNo

Public Health and Safety Statement for Rockdale Temple Students, Madrichim, and Staff
2021-2022 | 5782

Public Health as a Jewish Value
Families send their children to religious school, youth group, and Rockdale Temple programs and assume that their children will enjoy themselves, have positive social interactions, learn from the rich Jewish environment, and be safe and healthy. One of our most cherished Jewish values is the imperative for preserving life and maintaining health. We embrace this value specifically by taking preventive measures to protect the public health of our community as a whole.

Routine Vaccination Policy
Any individual who attends as a student, serves as a madrich/a/ol, and/or teaches in our Kehal Kodesh School (whether children or adults) must have up-to-date, age-appropriate vaccines as recommended by the American Academy of Pediatrics (AAP) and the Center for Disease Control (CDC). If your child has a medical exemption from vaccinations, please contact Rabbi Binder. Please sign electronically on your online registration form to signify your understanding of this sacred trust.

COVID-19 Update
Since the Kehal Kodesh community is made up largely of a community of unvaccinated youth, we are closely monitoring the COVID-19 situation. As such, our program this year has been formulated based on guidelines from the CDC and AAP, and shaped for our Kehal Kodesh community by our Rabbis, Health Safety Team, and Religious School Committee. We are requiring our faculty and staff to be vaccinated, and strongly recommending that students age 12+ be vaccinated. We are also committed to outdoor activities, mask policies, and sacred distancing depending on the current state of the COVID-19 pandemic. These will be ongoing assessments and we greatly appreciate your patience and partnership as we work towards creating a safe and inclusive community together.

If you have any questions or would like to discuss these issues further, please contact Rabbi Binder.

For 2021, do you agree to the above vaccination policy?

I have read and understand the above vaccination policy and verify that my child(ren) are vaccinatedOther - please have Rabbi Binder call me to discuss.Please note: if you do not agree to the above policy and your child(ren) does not have a qualifying medical exemption, we are unable to enroll them in religious school.

STUDENT, FAMILY, and SCHOOL BRIT (COVENANT)
2021-2022 | 5782

וְשִׁנַּנְתָּם לְבָנֶיךָ – v’shinantam l’vanecha – And you shall teach them diligently to your children (Deut. 6:6)

Our Torah teaches that each of us has an obligation to impart to our children the rituals, texts, observances, and values of Jewish tradition. As creators of a true kehal kodesh, a sacred community, we invite students, teachers, and families to work to together to help our children embrace a life of Jewish learning and to form strong, positive Jewish identities. We invite you to review this brit (covenant) as a family. Please sign electronically on your online registration form to signify your understanding of this sacred trust.

PARENTS AND CAREGIVERS will:

send your children to school REGULARLY and ON TIME
participate in Sunday t’filah (prayer services)
show an interest in what your children are learning
make Religious School one of your children’s priorities
periodically attend Shabbat services with your children
attend family education and family-oriented school events
communicate with faculty/staff if problems arise
encourage students to approach Religious School with the same commitment as they do secular school

STUDENTS will:

attend school regularly
approach your education with dedication:
- come to school regularly and on time
- arrive prepared to learn
- participate in activities, discussions, and projects
behave appropriately in school:
- respect the dignity of everyone in the school community – rabbis, teachers, staff, madrichim, and peers
- respect your own property, the Temple and JCC, and the property of others
- work to ensure that the school environment is safe for you and others
periodically attend Shabbat services with your family

KEHAL KODESH SCHOOL will:

provide teachers and staff committed to excellence in teaching
provide support materials necessary for learning
create a safe and nurturing environment conducive to learning and the development of self-esteem
respect and provide for the needs of individual students
maintain on-going communication with parents and caregivers
demonstrate a love of Judaism and dedication to Jewish living and learning, and contribute to students’ positive Jewish identity

Kehal Kodesh School of Rockdale Temple instills knowledge and love of Reform Judaism.
We provide pathways to spirituality and God through instruction in Torah, ritual, traditions, Tikkun Olam (social responsibility), and connections with our sacred community. Inspired by our mission, Kehal Kodesh School aims to provide our students with an excellent Jewish education, focused on our values and traditions and rooted in the belief that all everyone is made b’tzelem Elohim, in the image of God. Our goal is to meet every child where they are, include them in our sacred school community, and offer the skills and opportunities to live Jewishly.

* Please sign electronically to signify your student(s) and family's understanding and commitment to our Brit (Covenant)